Denial Management Services
Remove Claim Denials Root and Stem Because All Denials Are Preventable.
- 100+ Denial management experts skilled in state, federal, and commercial payers.
- Resolve soft, hard, clinical, and administrative denials.
- Reduce denials with our analytics expertise.
- Automated denial management services.
Save time, money, and energy by outsourcing the denial management service.
Quick Inquires Form
Why do you need denial management services?
Around 90% of claim denials can be prevented or resolved, with many arising directly from staff oversight. Here at Pathwayhms, we have assembled a team of premier medical coding and billing professionals, carefully selected for their expertise in the field.
Best Denial Management Practices We Follow:
- Categorizing Denials
- Identifying Denial Causes
- Pre Auditing Claims Before Submission
- Timely Resubmissions
- Using Denial Management Software
Who We Serve?
Health Systems
We help to grow revenue and maintain positive cashflows
Group practices
Automate and standardize medical billing & RCM processes with our feature- packed, user focused RCM tools.
Hospitals
Complete revenue cycle management and operational support that is built from the ground up for you
Pathwayhms Denial Management Service Results
72%
Decrease in the denial rate.
45%
Reduced Operational cost
32%
Reduction in DNFB accounts.
72%
Productivity improvement.
36%
Reduction in aged A/R.
98%
Achieve net collections.
Major Specialties Denial Management Service by Pathwayhms
Internal Denials Management
Pediatric Denial Management
Family Service Denials Management
Cardiology Denials Managements
Orthopedics Denials Mangement
OB-GYN denial management
Nephrology denial management
Oncology denial management
Radiology denial management
Dermatology denial management
Urgent Care denial management
Surgery denial management
Health Systems
We help to grow revenue and maintain positive cashflows
Group practices
Automate and standardize medical billing & RCM processes with our feature- packed, user focused RCM tools.
Audit Control
The audit control system monitors the complete claim history, from initial submission to final denial or payment, eliminating the need to switch between PMS, EHR, and denial tools.
Appeal Automation
Most payer appeal forms are available for reference, and if necessary, the required appeal form can be uploaded.
Denied claim details are automatically filled in the appeal form.
Skilled Denial management Staff
Pathwayhms’ experienced denial management specialists have more than 5 years of expertise spanning various specialties, insurances, and states, providing them with a distinct advantage in comprehending insurance guidelines and averting denials.
Our Denial Management Tool
Our denial management tool boasts an inventory for enhanced responsiveness, featuring analytics that generate 13 default pre-set denial maps. The tool is customizable for unmapped denials and automatically populates errors and denials, offering resolutions for denied claims.
RPA Denial Management Technology
Pathwayhms RPA denial management technology has demonstrated enhanced productivity, quality, and efficiency in comparison to denial management staff (FTE), enabling your healthcare organization to maintain 24/7, 365-day denial management operations.
Compliance and Certifications
