DME Service Solutions

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Denial Management

Effective Denial Management can significantly boost revenue for healthcare providers. Given the complexity and dynamic nature of healthcare billing, investing in our dedicated denial management team is a wise and prudent choice for many healthcare organizations.

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Turning Denials into Dollars with Our Proven Denial Management Process

Recover lost revenue and cut down on in-house management costs with our efficient Denial Management process. From identification to appeal, our comprehensive approach ensures every denial is addressed swiftly and effectively. Consider us an extension of your team, dedicated to providing the attention your claims deserve for faster reimbursements.

Our Denial Management Process Steps

  • STEP 1: IDENTIFICATION OF CLAIMS

    To streamline the process, we capture and segregate claims based on their status - whether they have been denied or rejected by the insurance companies or approved.

  • STEP 2: CATEGORIZATION AND CLASSIFICATION

    Our claims are meticulously categorized, ensuring a comprehensive understanding of denial reasons. Common causes for denials encompass coding errors, missing or incorrect customer information, issues with client eligibility, and insufficient documentation.

  • STEP 3: ROOT CAUSE ANALYSIS

    Our process involves conducting a thorough examination of the factors leading to denial. This helps us understand the root causes and implement preventive measures to minimize future denials.

  • STEP 4: CORRECTION AND RESUBMISSION

    After identifying and understanding the denial reason, necessary corrections are made to the claim, such as fixing coding errors, updating healthcare customer info, or adding required documentation. The corrected claim is then resubmitted for reevaluation.

  • STEP 5: TRACKING AND FOLLOW UP

    We track the progress of resubmitted claims with regular follow-ups to ensure timely payment.

  • STEP 6: APPEALS PROCESS

    To begin an appeals process, we gather supporting documentation and formally request the insurance company to reconsider a denied claim.

Our End-to-End Denial Management Services

Our holistic solution led by denial specialists maximizes revenue, improves efficiency, and allows healthcare providers to focus on quality healthcare client care.

Our expertise in denial management benefits clients by streamlining the complexities, facilitating fair and timely compensation. This improves financial health and allows a primary focus on delivering healthcare services.

An efficient denial management process identifies and rectifies systemic issues, reducing the risk of repeated mistakes. This brings significant advantages, including minimizing associated financial implications.

Build your outsourced clinical denial management team to cut down in-house costs and improve revenue.

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Why Choose Our Denial Management Services

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Revenue Recovery

Efficient denial management helps recover significant revenue by addressing denied claims. It ensures that providers are paid for the services they deliver, mitigating potential revenue loss.

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Operational Efficiency

Our dedicated denial management service team optimizes operations, reducing administrative burdens on healthcare providers and simplifying the complex, time-consuming process of handling denials, to their advantage.

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Risk Reduction

Our effective denial management process can identify and rectify systemic issues leading to denials, reducing the risk of repetitive mistakes and associated financial implications.

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Cash Flow Stability

Effective denial management expedites claims reimbursement, providing healthcare institutions with predictable and stable cash flow, without the disruption caused by delays or denials.

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Improved Healthcare Customer Satisfaction

Prompt resolution of billing issues results in fewer financial uncertainties and complications for patients, providing better overall patient experiences.

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Transparency And Accountability

We offer regular reporting and performance metrics, ensuring transparency and being accountable for results, giving you the advantage.

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DME Service Solutions - A Leading Denial Management Company in the Healthcare Industry

At DME Service Solutions, we take pride in being a human-centered BPO company that caters specifically to the healthcare industry. Our team is highly engaged and specialized to meet your unique requirements. We understand the importance of customer satisfaction and strive to provide tailored solutions that enhance your operations. Our commitment to partnering closely with you sets us apart in the industry and allows us to deliver the best possible service. At DME Service Solutions, our goal is to help you achieve your objectives and exceed your expectations.

+347%

Maintained support for Increase in call volume

-41%

Decrease in average days to collect documents

~15

Days average TAT for hiring

+166%

Increase CGM Orders YOY Q1-22 vs Q1-23

94%

Consistent service level results

-17%

Decrease in avg handling time​

Build your outsourced team to streamline your business performance and increase your customer satisfaction.

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