Denied Claims Solution
Denied claims are a major source of concern to most hospitals. The effective rate of reimbursement for managed care billings can be severely reduced because of claims underpayments and claims denials. Some HMOs are systematically denying payment on nearly 25% of all submitted claims. Those claims will not be paid unless the hospital submits a resubmission or appeal within the allotted time constraints. Denied stamp
Many hospitals do not have sufficient resources or expertise to handle this substantial volume of extra work. Denial management software can be a great tool to help you track denied claims, but it does not contact the insurer and fight to get the claim paid. You still need experienced professionals to do the work.
Leco uses proprietary software to track your denied claims and to determine the most effective responses. We also provide a highly-motivated staff with expertise in managed care contract interpretation, clinical appeal and collection. This combination of specialized professional resources insures maximum recovery.
We identify all your denials immediately after posting, then use our proprietary software to determine the most effective course of action, Our staff uses remote access into your billing system to research each claim. We quickly complete the necessary actions, including clinical reviews when necessary, and submit the appeals within the filing deadlines. Finally, our collection specialists tenaciously follow up with each payer to insure quick and accurate payments.
This methodology has proven effective in maximizing the recovery of denied claims. We can typically reduce your overall denial rate.. In addition, we provide you with valuable statistics on denial rates and net collections by payer or by type of denial. This can help you to eliminate some sources of denial and can assist you in future contract negotiations.