Improve Revenues by addressing claims denied due to Coding issues

Coding Denials are a significant component of claim denials.  While the most cost-effective mechanism for recovering revenue is to ensure that optimal payments are received the first time a claim is submitted, more than 10% of claims are denied even for well-run revenue cycle departments.

Denied claims require a complete review of the reasons that caused the denials. Denials on account of incorrect coding or other coding issues need a comprehensive process, including retrieving medical records, reviewing the medical codes ascribed, assessing the clinical documentation, performing coding edits in line with payer-specific guidelines resubmitting the claim. The process is labor-intensive and time-consuming, draining the resources of the coding team.  

Clority Healthcare offers comprehensive coding denial management services to help you manage the labor-intensive process. We also provide coding audit solutions to help you prevent coding denials significantly. 

Did you know? Providers do not resubmit or appeal as many as 65% of claims denied!

Due to the intense resource requirements for appealing denied claims, Providers do not resubmit or appeal as many as 65% of the denied claims. Lack of staff and lack of certified medical coders are the common reasons cited by most revenue cycle administrators. As keeping the lights on takes precedence, the focus shifts to processing newer claims rather than addressing denied claims. 

Our Denial Management Services

Clority Healthcare brings the advantage of efficient processing, denial management expertise, and offshore price structure to bring you a cost-effective denial management solution. Our training programs for denial management personnel and structured policies and procedures for addressing each denial code helps us identify issues with the claim and manage them effectively to allow you the ability to collect lost revenue. 

Medical Coding Expertise 

For addressing coding-related claim denials, we utilize certified coders with experience in the specific specialty. With their experience and expertise, they can narrow down on the issues, apply the right medical codes – using the suitable modifiers as per AMA guidelines, and apply CCI (Correct Coding Initiative) edits. 

Improve reimbursements and reduce coding denial management with Clority Healthcare’ expertise in medical coding and denial management