Denial Management Services For Emergency Medicine Physicians

DUVASAWKO IS THE EXPERT IN DENIAL MANAGEMENT SERVICES FOR EMERGENCY MEDICINE PHYSICIANS

Data from the AAFP suggests that between 5 and 10 percent of medical claims are denied. In another report from the Government Accountability Office (GAO) the rates are even less optimistic, stating a full 25 percent of claims are denied. Denial rates from individual providers vary as well, showcasing the lack of standardization within the healthcare industry and highlighting the challenges EM groups and facilities have with denial management services on a daily basis.

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Effective Denial Management

Denial management is the practice of evaluating why medical claims are being denied, determining best practices for reducing the number of denials, and employing strategies that increase  the percentage of claims paid  promptly the first time.

Effective denial management includes  the following:

  • Identifying the reason(s) claims are denied
  • In-depth Reporting & Analytics that provide full visibility into your practice’s performance
  • Decreasing the overall number of denials and maximizing the number of claims paid promptly

If you run an Emergency Medicine group or facility, you have probably experienced one or more of these common reasons for insurance denials:

  • Incorrect coding by the provider
  • Healthcare services provided outside the beneficiary’s network
  • A general lack of documentation to support claims
  • Incorrect patient information such as misspellings or inaccurate information given by patient
  • Non-coverage of certain services/lack of prior authorization from insurer before conducting treatment

Of course, no EM practice has the time to address these denials . These denials negatively affect cash flow and providers’ ability to dedicate time to patients.

DuvaSawko is there to help.

BEST DENIAL MANAGEMENT PROCESS: WHY SHOULD YOUR EM PRACTICE OUTSOURCE DENIAL MANAGEMENT?

DuvaSawko’s robust front-end edit process is implemented daily to ensure optimal performance and response to denied claims. Our detailed and effective appeals process for improperly denied claims can measure and track all denials and reasons through the use of proprietary transaction codes .

Here are four reasons your EM practice should partner with DuvaSawko to manage your claim denials:

1. Improve cash flow

When you partner with an emergency medicine Revenue Cycle Management specialist such as DuvaSawko, you will instantly see a decrease in insurance denials. DuvaSawko’s expertise will ensure that the Claims will be less likely to get denied. This, in turn, will speed up the collection process. This not only helps with your practice’s efficiency, but also gives you more time to grow the practice.  At DuvaSawko, we have a 99% success rate in overturning denials!

2. Increase profitability

When you partner with us, you are aligning your organization with a team of expert coders, billers and denial management professionals who are exclusively dedicated to helping you get every dollar you are owed. In addition to having improved cash flow, you’ll be able to free up valuable administrative resources so that you can focus on providing excellent and profitable patient care.

3. FREE-UP ADMINISTRATIVE RESOURCES

Consider the current resources allotted to Revenue Cycle Management in your practice If these employees were ever to leave (turnover), take a vacation, or have other conflicting obligations, could you afford the impact this would have on your profitability? By outsourcing  denial management to  specialists at DuvaSawko, you won’t need to never worry about employee turnover, continuing education, vacations, software updates, hiring or firing, or any related aspects of employing billing staff.

4. Minimize Errors while Maximizing Reimbursements

When your practice partners with DuvaSawko to handle denial management services, you are ensuring the proper submission of insurance claims, proper coding, and accurate documentation. This translates into helping your practice get paid more quickly. A further benefit of this type of outsourced RCM relationship are maximized reimbursements. DuvaSawko as we will oversee the entire process from the initial patient interaction all the way through the final collection process.

Why Work With DuvaSawko’s Claims Denial Management Team?

“Switching to DuvaSawko 14 years ago was one of the most cost-effective financial decisions our 90 plus emergency physician group has ever made. Since billing is our second largest expense after physician payroll, we need to get as much bang for the buck from billing as we can. Their coding expertise, their clean electronic interfaces with the payers, their excellent patient call center, and their aggressive backend follow up have produced better end results for us than the other billing companies (both financially and from a patient satisfaction standpoint).”
Paul Davidson, MBA
EM Group Administrator

Get Your Complimentary Practice Analysis Today

Awareness of your practice’s financial health will help determine just how profitable your practice can be. The team at DuvaSawko knows what it takes to be a successful Emergency Department practice.

We have shown practices how to positively impact revenues by between 10 and 30% annually.

Don’t leave any more money on the table. Talk to the team at DuvaSawko today and schedule your complimentary practice analysis.