AR Follow Up & Denial Management

Overview

Claims denials are one of the biggest challenges faced by providers today. Through careful review and efficient tracking of insurance policies & key performance indicators, we have identified that around 85% of those denied claims are avoidable.

Inefficient AR Follow UP practices in RCM Firms & Hospitals have led to billions of dollars being lost in revenue due to Uncollectable denied claims in the US healthcare sector.

Top Causes that we have identified with thorough research & combined experience of our team of experts at 3AG

Incomplete or Inaccurate Patient Demographics
Unmet Pre-Authorization Requirements/Processes
Submissions Past Timely Filing Limits
Improper Secondary and Tertiary Payer Filing Coordination
Non-compliance with Payer-specific Rules
Failure to Appeal Denied Claims on time
Unorganized Claims Tracking and Status Monitoring
Failure to monitor Provider Credentialing and Enrollment
Unrefined Coding Practices & Bundling Issues
Unflagged Duplicate Submissions
Medical Necessity Review Errors - (Both from Payer Policies & UM Standpoints)
Poorly Managed Contracts with Insurances

Our custom approach to each claim denial ensures effective and timely resolution as our team of experts at 3AG ensure timely intervention & do what needs to be done to reverse the denial, processing the claim towards payment.

Medical practices should aim for a 95% clean claims rate; otherwise, it is bound to affect the cash flow of your practice and eventually affect overall functionality. Maintaining a high clean claims rate increases your medical practice's efficiency and overall profitability.

If your practice continues to have claims denied, your insurance reimbursements will decline. Many practices work on small margins, and even a slight change could put your practice at risk. This is why 3AG Healthcare Services Inc. offers to manage these denials for you & help avoid even the slightest errors

Given that clinics/facilities are bound to come across claim denials, be it a genuine denial or an error in insurance processing parameters, it's crucial to establish verification & follow up systems to monitor the accuracy and timeliness of claim submissions, adjudications, and payments. Regularly reviewing claim data can help identify trends, errors, and opportunities for improvement.

Partner with 3AG & obtain real-time insights directly from our analytical review tools that consistently track key performance indicators to identify trends, spot areas for improvement, and optimize workflows.

With our powerful analytics tools, you'll stay on top of your organization's progress and make data-backed decisions that drive your success to new heights.

Few of our suggestions & practices at 3AG, that make us the best in AR Follow UP & Denial Management

Outsourced Denial Management Services
Dedicated Denial Management Team
Client-Specific Strategy Sessions & Improvement Initiatives
Proactive Prevention Strategies for EDI Rejections
Effective Denial and Root Cause Analysis
Robust Documentation Protocols on Follow UP claims
Priority Handling of High-Value Claims/Aging AR Claims
Clear Denial Categorization & Trend Captures
External Audits and Compliance Checks
Realtime Performance Metrics and Reporting
Client-Centric Approach & Customizable Denial Reports
Integration of AI Tools & Analytical Tools to track Denial KPIs & Trends
Consistent evaluation and monitoring of payer policies

Get the best of both worlds for next-level AR Follow UP & Denial Management

Let the largest and most tenured RCM team in the industry manage your entire billing process—from claims submission to collection.

As integral members of the US Healthcare ecosystem - 3AG has consistently remained at the forefront of innovation, particularly in the realm of Automation and Artificial Intelligence (AI) 3AG's

Information & Development Team has implemented numerous integration into our automated workflows, which our partners are already working with, and intelligent algorithms have shown us a significant reduction in manual intervention, minimized errors, and expedited the reimbursement process for healthcare providers.

Along with being focused on viable future applications in terms of AR Follow UP & Denial Management - 3AG offers RCM Firms & Providers with highly experienced professionals and a team of support staff who have been collectively trained to understand the insurance workflows, which help them better navigate claim follow up and denial management.