Auditing and Denial Management Tool Kit helps you understand your denials, better manage your claims process, and audit claims and administrative procedures to identify any underlying problems that can lead to denials. From appropriate data collection and claims submission to payer inquiries, denial management, appeals, and auditing—you'll submit the right information up front, and you'll know exactly how to correct denied claims so you can improve the revenue cycle process.
Key features include:
- Ingenix Edge — Establish and maintain an effective denial management process. Understand how to efficiently resolve denied claims, decrease "at risk" claim filing procedures, limit liability, or correct and appeal claims and receive your money faster.
- Ingenix Edge — Quickly respond to payer inquiries, and understand and address the various types of remittance advice codes utilized by payers. Detailed explanations of the top denials codes are provided with examples and action alerts.
- Audit claims and processes to find the underlying problems that cause denials. Identify the root cause of denials and take action to prevent delayed or denied payment or at-risk behavior. Understand the processes necessary to audit and review existing claim and workflow to optimize "best practices" and minimize revenue cycle pitfalls.
- Understand how to efficiently resolve denied claims with an emphasis on avoiding future denials through appropriate work flow processes, reduce potential liability from erroneously submitted claims, effectively utilize the appeals process to ensure the best possible outcome, and implement techniques to assess and audit existing revenue cycle processes.
- Includes searchable CD. Easy access to printable templates to help improve your appeal and resubmission processes. Simply search the contents of the manual for key topics.
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