While many denials are best handled by submitting an appeal, other denials have more to do with the claim cycle. Sending an appeal with medical records won’t make a difference if the denial has to do with the claim itself.
At HLS, we make use of our root cause analysis to determine why each claim is denied and what steps are needed to get it paid. We often find that we can get a denial or underpayment overturned simply by submitting additional information or a corrected claim, or by asking the payer the reprocess the claim. With our in-depth understanding of the requirements for claim processing, we can identify processing errors and rectify them effectively through the claims department, rather than going through the costly and time-consuming process of filing an appeal.
To learn more about how HLS uses our experience with the claims process to increase revenue for hospitals, click here to read some of our case studies