Accounts Receivable & Denial Management Services

In healthcare, time is money. Nothing is more critical to a healthcare organization’s profitability than to have an efficient and effective accounts receivable and denial management process. With our years of experience, we are able to significantly improve your business’ cash flow, reduce A/R days and decrease unwarranted write-offs effectively.

Accounts Receivable Management

Issues with A/R will directly impact a provider’s margins, debt and organizational financial health. Therefore, A/R management is vital after claim submission and crucial for financial stability. It identifies the adjudication status of the submitted claim and helps in understanding the claim outcome. Early notification of a denial helps correct the claim at the initial stage and saves it from becoming ‘untimely’ for appeals or corrections. Our team will analyze your financials, identify errors and implement efficient processes to collect payments and clear backlogs of unresolved A/R within a quick turnaround time.

Our Accounts Receivable Management Services

  • Follow-up across all payers on outstanding A/R
  • Inherited A/R cleanup projects
  • Underpayment management
  • Denial management
  • Credit balance resolution
Accounts Receivable Management Services
Denial Management Services

Denial Management

The average claim denial rate in the healthcare industry ranges from 5% to 10%. Most providers consider these denied claims as a drain on resources and negatively impact revenue. Many providers, however, do not realize just how significant that impact is. Data shows that 90% of denied claims are preventable and up to 65% of denied claims are never resubmitted, even though 63% of denied claims are recoverable. This is money left on the table. Our effective denial prevention strategy and dedicated denials team can help your organization increase payment recovery. This is done by identifying the root cause of denials, reworking the denials, writing appeals if necessary and resubmitting claims.

Our Denial Management Services

  • Identifying and correcting root causes of denials
  • Contacting payers and patients to gather additional information
  • Preparing appeals, correcting claim information and resubmitting corrected claims

Our A/R & Denial Management Approach

With our systematic approach, you can obtain a good resolution rate on high dollar accounts receivable. Some of our offerings include:

In-depth pre-call analysis with the help of EOBs and system notes

A/R analytics along with ad-hoc reports and denial dashboards

Work prioritization & allocation on the basis of claim age, claim value, payer category, etc.

Core analysis of denial reasons and denial trends

Professional team dedicated to stay on top of the collections process

Re-engineering along with providing relevant solutions for healthy A/R

Benefits of Our Accounts Receivable & Denial Management Services

Our customizable solutions are designed to track critical KPIs, improve clean claim rate and optimize your A/R and denial management processes. In short, you can trust us to convert your receivables to revenue.

  • Timely reimbursements
  • Reduced denial rate
  • Reduced A/R days
  • Operational efficiencies
  • Sustained cash flow
  • Low cost to collect
  • Quick turnaround time
  • Access to skilled and experienced resources
  • Cost-effective solutions
  • Customized reports
  • Claims handled for all payers
  • Updated on industry regulations

Analytics through U-Track

Over the years, 3Gen has been adopting and implementing cutting-edge technology to transform its clients’ business with technological enhancements. One such example is U-Track, which is a performance monitoring and workflow management system, developed in-house by the 3Gen software team.

Monitors daily workflow

Generates customized management reports

Tracks volume and helps manage/allocate priority and higher maturity dates records

Tracks daily productivity and turnaround time for each resource

Provides management real-time dashboard on daily volumes assigned by the client and work completed by the 3Gen team

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