Copyright (c) - Leco & Associates - All rights reserved.
Helping hospitals achieve fiscal fitness.
 
who we are
what we do
meet our team
references
press releases
contact us
 
 
 
 
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. Many of those are claim denials, that will not be paid unless the hospital provides resubmission or appeal within the allotted time constraints.
 
 
Most 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 effective systems coupled with specialized professional resources insures maximum recovery.

We capture your denial information immediately after you post cash. Our proprietary software uses denial-code dictionaries and payer profiles to determine the most appropriate course of action, then 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 well within the filing deadlines. Our collection specialists tenaciously follow up with each payer to insure quick and accurate payments.

Our methodology has proven effective in maximizing the recovery of denied claims. We typically reduce your overall denial rate and significantly increase your rate of collection on your managed care billings. In addition, we provide you with valuable statistics on denial rates and net collections by payer to help you negotiate better terms on future contracts.