Insurance Denials Management
Each year, health insurance companies and government payers process – and deny – hundreds of millions of claims. Revco Solutions partners with hospitals, health systems, and physician groups to supplement the time-consuming process of coordinating with payers to collect payments owed from patients and payers alike.
Additionally, through a new strategic partnership with ARMC Recovery, a Revco Management Company, we are capable of implementing a more aggressive denials management strategy on your behalf. We can put our specialized denials division, utilizing a proprietary Denials Management System (DMS) software, to work for you, ensuring proper and consistent appeals activity on all denied accounts, until resolution.
A Look at Our Process:
Step One: Assignment
The denied account is assigned to a denials specialist who will review the account and contract matrix to determine the reason for the denial. In most cases, we will contact the payer by phone to confirm the reason for the denial and the steps necessary to appeal or resubmit the claim for payment. And while our sophisticated, system-driven process ensures continuity of activities and protects against untimely filing issues, our automated system acts as a backup to ensure that no account falls through the cracks.
Step Two: Claim Resubmission or Appeal
Depending on the reason for the denial, our denial management process may include a simple correction or provision of pre-certifications and other necessary documentation so that the bill can be re-processed and paid. Denials for medical necessity will be reviewed by a clinical biller or physician, and we will work to compile all necessary documentation for appeal.
Step Three: Payment
Payments will be made directly to you, and Revco Solutions will compile robust reporting on all denial activities, account statuses, and payments to keep you up-to-date.
Ready to stop writing off denials? Answer just a few simple questions to get started.