Denial Management for Hospitals

 

Years of experience have taught us that to truly prevent denials, organizations must allocate adequate resources to target a variety of front-end processes. As a result, our team has incorporated a robust workflow management system and business intelligence-reporting tool into our denial management strategy, to quickly isolate root causes and overturn denials when they occur.

Denial Prevention

Whether a hospital experiences clinical or technical denials, tracking where the problem originated, and figuring out how to fix the problem is usually time-consuming, if not nearly impossible.  Interpoint knows that your end goal in denial management isn’t just to recover denials retrospectively, but to prevent their occurrence in the first place.   Interpoint’s approach gives hospitals the valuable information they need to put an effective denial prevention program in place. 

The Interpoint Advantage

Interpoint takes the guess-work out of managing denials by giving providers the knowledge to locate, analyze, recover and correct the root cause of denied claims.  Given the financial climate of healthcare today, this has never been more important – millions of dollars are lost every year due to denied claims that could have been prevented.  It’s no wonder that more and more hospitals are evaluating different internal processes and new systems to reduce claim denials and capture every dollar they can.

Taking a comprehensive approach, our solution gives hospitals the ability to drastically reduce denials and improve their revenue stream.

Identify – Find and quantify the Issue

  • Identifies the cause of all denials – by payer, denial type, denial reason, etc
  • Normalizes denial code data across all payers and all payment compliance issues – giving visibility to the whole problem, not just a portion
  • Applies expected reimbursement to help quantify the issue
  • Enables User to create compliance denial alerts based on rules

 

Recover – Streamline the Process

  • Accelerates the appeal process by having contractual details available at the click of a mouse
  • Simplifies recovery by automated workflow creation
  • Increases staff efficiency and enhances job satisfaction due to user-friendly nature of the application

 

Correct – Remedy The Cause(s) and Continue Tracking Results

  • Tracks and reports on all key elements within the payer contract
  • Addresses payer compliance issues across all payers, including government