Denial Appeals and Management

Our skilled team provides denial management services by filing appeals on your behalf. We offer the following medical billing services to appeal insurance company denials:

Insurance provider follow-up

Daily claims audits

Denial monitoring

Claim resubmission

Denials Management Services in San Diego

Denials Management Services

Appealing insurance company denials is a crucial part of our denial management services. Even if we prevent the most common causes of claim denials, such as late filing or incorrect coding, insurance companies may still deny claims for other reasons. Our experienced team is equipped to file appeals for denied claims and make any necessary changes to the claim before refiling.

  • Claim Denial Management Services: Even with accurate coding and claims management, some claims may still be denied by payers. Insurance companies may look for ways to avoid paying claims, but our team manages the denial process for you. We either appeal the denial or refile the claim as necessary to maximize collections.
  • Daily Claims Audit: To stay on top of outstanding claims requiring follow-up with insurance providers, we perform a daily audit of all active claims. This also enables us to promptly identify denied claims.
  • Claim Resubmission: Failing to appeal or resubmit denied claims can result in missed collections for many medical professionals. Our denial management services handle this process for you, ensuring that you can focus on your practice. We determine whether a claim can be appealed or resubmitted, and work to maximize your collections.
  • Follow-up with Insurance Payers: Effective follow-up with insurance companies is a critical component of claims management. We keep track of all claims filed on your behalf and reach out to payers when necessary to ensure timely processing and maximum collections.

A More Profitable Practice – Increase
collections by 15%

INHOUSE MEDICAL BILLING

$1,200,000 revenue

  • $45,000 biller salary
  • $40,000 secondary biller salary
  • $23,750 Benefits and Overhead @ 25% of salary
  • $3,000 Cost of software and hardware for billers
  • $1,200 Cost of Postage

$1,087,000 in net collections

Average billing expense of 10.25% of collected revenue

OUTSOURCED MEDICAL BILLING

$1,400,000 17% increase in top line collected revenue

  • $77,000 5.5% of collected revenue

$1,323,000 in net collections

Average billing expense of 5.5% of collected revenue plus the added collective revenue from outsourcing

Maximizing Collections with Denial Management in San Diego

Maximizing Collections with Denial Management

Handling claim denials and appeals is a critical component of our billing services. Even with the best coding and claims management practices, some claims may still be denied by insurance companies. However, our team of experts is equipped to manage the process for you and appeal or resubmit the claims as needed, ensuring that you receive all the collections you are owed.

Maximize Your Collections

By managing claim denials and appeals, our services help medical professionals to maximize their collections and avoid losing out on profits due to missed claims. We handle the time-consuming process of resubmitting or appealing denied claims, allowing you to focus on providing care to your patients. With our support, you can rest assured that all eligible claims will be pursued and your revenue stream will be optimized.

Receive Collections Faster

Outsourcing your denial appeals to a professional billing company can have the additional benefit of reducing the amount of time your claims are stuck in an insurance company’s accounts receivable (A/R) department. By handling the appeals process in a timely and efficient manner, we can help you receive your collections up to 19 days faster than if you were to manage the process on your own.

Reduce the Risk of Denials

Even with the best medical billing practices, there is always a risk of an insurance company denying a claim. However, we take steps to minimize that risk. Our team files claims based on each payer’s unique requirements, utilizes our extensive knowledge of CPT codes, and ensures timely filing of claims to help reduce the likelihood of a denial.

Testimonials

What our clients are saying

Branden R.
Branden R.
22:38 03 Aug 23
I spoke with Brian today from Sharp Management Solutions. He was a pleasure to chat with and he seems very knowledgeable. Having your medical billing handled by specialists seems like a great way for medical offices to spend less effort and collect more money from their patients at the same time.
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If you're tired of the stress and hassle of managing your medical billing in-house, contact us today to learn more about our reliable and cost-effective medical billing services and start streamlining your operations for increased efficiency and profitability.