Denial Management Reduces Unpaid Claims and Increases Cash Collections


DMDS subscription-based service helps healthcare providers understand, correct, and receive payments, addressing revenue issues.

Our leading national revenue cycle management software and solutions provider has announced the immediate availability of its new Denial Management and Decision Support (DMDS) solution. It is an advanced analytic engine that helps healthcare providers of all sizes better understand, correct, and receive payments and better organize the business to deal with payer- and patient-related revenue issues.

Industry statistics point to the negative impact of underpayments and unpaid claims. According to data from Physicians Practice magazine, denial rates can range from 5 to 20%. More alarming is that on average, 3.5 to 4% of providers’ monthly billings are simply not paid.

Our denial management solution enables providers to collect much of this lost income at minimal cost. Denial Management and Decision Support is a subscription-based service that converts revenue cycle data into actionable information. It also establishes best practices that can be used to pursue continuous improvement.

For example, the Solution can quickly identify and prioritize unpaid claims, enabling administrators to assign appeal based on workflow needs. These key characteristics enable staff members to become skilled at working high dollar denials from particular payers, learning that company’s idiosyncrasies and effectively pursuing redeterminations.

Other valuable reports analyze patient payment data to determine the increase in consumerism and patient responsibilities within a provider’s healthcare business. Providers are able to track changing patterns in co-pays, deductibles, and co-insurance with comparative data across payers enabling providers to strengthen patient collections tools and procedures. The broader benchmarking capabilities allow providers to compare performance—whether financial or operational, such as coding practices—within the business and to national averages.

The Denial Management and Decision Support Solution is available in two subscription options, ensuring that every provider can find a solution that is both affordable and valuable to its needs. DMDS Basic offers workflow solutions to help manage denials, zero-paid claims and reversals/corrections; it also helps users post payments, keep patient information up to date, and mitigate the impact of Recovery Audit Contractor (RAC) audits. DMDS Professional adds nine analytical reports that support the strategic decision-making of managers, administrators and owners.

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Nov 02 2009

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