CareMedic Systems

OptimizeAR Denial Management

OptimizeAR Denial Management provides the tools to track and control your denied claims—and to prevent them from occurring in the first place. Denied claims can cost the average organization as much as 3 percent of patient revenues each year—which translates to millions of dollars of avoidable write-offs.

To complicate the situation, denial collection and follow-up activities depend on multiple systems that don’t typically share information. Without a start-to-finish view of claim activity, claims disappear, deadlines are missed, and money is lost. It’s also nearly impossible to pinpoint problem areas or track productivity in a timely manner. In addition, labor-intensive manual processes result in inaccurate or incomplete information that leads to denials, rejections and more work to correct the errors.

This module automates denial management processes using "event-driven workflow" based on your business rules. Automated processes eliminate potential errors, enabling staff to focus on more productive activities. Denial Management also wraps around your existing systems to connect and track denied claim events.

Denial Management offers a number of unique features:

• Connects information from disparate systems to provide a single view of denial activity
• Automatically monitors and routes claim data to individual work lists based on denial events affecting the claim
• Provides denial reporting that contains a high-level denial impact picture, plus the ability to drill in to see specific impact points.

Benefits:

• Eliminates "black holes"
• Automates workflow, greatly increasing efficiency.
• Allows individual and departmental productivity monitoring
• Increases revenue
• Reduces write-offs

OptimizeAR Denial Management includes a reporting solution that uses the received 835 information to clarify the causes of your denied claims so that you can take corrective action, avoid future denials, and collect more cash. With its standardized denial views, powerful ad-hoc reporting and drill-through functionality, this module helps you identify and correct denials thoroughly and efficiently.  The result for your organization is the ability to identify sources of denials, an increased ability to collect payments, standardized denial categorization, improved analysis of denials and increased efficiency and denial prevention.

For more information, contact us via the Web or call 1-800-508-8494.