Denial Management

Our denial analysis tools allow us to identify most common denials and their causes. We then work with our clients to develop an action plan and make sure corrective measures are taken to reduce those denials and improve revenue recovery in the future.

At Upscale Healthcare Billing Solutions(USHCBS) our Denial Management team follows a strict process that Includes

Charge Entry Analysis – Check claims in real time to verify diagnosis and procedure codes as you type to ensure compliance before submittal.

Sophisticated Rules Engine – Track payer denial activity and identify new rules. Web-based systems can anonymously track these rules over the user base and automatically distribute new rules over the entire network for complete claims qualifications.

Claim Alerts – Automatic responses for events like claim resubmissions and claim status to enhance payment transparency and ensure that money doesn’t fall through the cracks.

In-Depth Analytics – Customizable real-time reporting to make sure claims are being paid in full and spot areas where improvements can be made.

Functionality and Flexibility – The ability to integrate with other software systems and be easily upgraded for changes in rules and coding.

Our Clients: