Overturn Denials.
Empower your team.
Create margin to provide better care.
There is an exponential increase in denials impacting health systems of all sizes.
Denial Increase Over Time
149 Hospitals have closed in the last 10 years.
Medicare Advantage Increase
When hospitals close, communities suffer
https://hitconsultant.net/2021/09/10/healthcare-deserts-goodrx-report/
You are not alone.
We have found that on average….
15-20%
of hospital claims are being denied.
75%
of claims are not being appealed because of staffing insufficiencies.
3-5%
of profit margins are lost to denials.
50-70% of denials can be overturned with a successful appeal
Fixing the problem is difficult because of three things.
-
Backlogged Revenue Cycle Management
Denials are increasing at a faster pace than revenue cycle teams can handle.
-
Staffing Shortages
It takes multiple years to build the skills to become an appeals specialist and the turn over rate is high.
-
Ever Changing Payor Requirements
Primarily driven by an increase in Medicare Advantage and Medicare Advantage providers.
We are here to help you.
We overturn denials.
How we do it.
Our proprietary software uses advanced data science, innovative machine learning algorithms, cutting edge AI, and iron clad security measures to identify opportunities for successful appeals and generate custom appeal letters for each specific case.
Each appeal letter is then strengthened with the experience and insights of our team of real human claims specialists to review and fine tune your appeal letter to maximize the success rate, all in a fraction of the time it would take to do manually.
Featured In.
Connect with Us
If you're looking to enhance your claim appeal processes, reach out to us! Provide your details, and our team will respond promptly. We’re eager to assist you in optimizing your revenue recovery!