Emdeon Denial & Appeals Services
Emdeon Denial & Appeals Services, part of the Emdeon Payment Integrity Services suite, helps providers overturn denied claims with a full service appeals offering. With 10 to 15 percent of a hospital's Government Managed Care and Commercial claims resulting in full or partial medical denials and 67 percent of these denials being recoverable through the filing of effective appeals, Emdeon Denial & Appeals Services navigates the complex appeals process to overturn denied claims for payment reducing unnecessary write-offs. From thoroughly reviewing medical records to effectively preparing and filing appeals, Emdeon Denial & Appeals Services manages your denied claims appeal processes from the start to resolution.
As a licensed InterQual review agency, Emdeon Denial & Appeals Services provides you access to our experienced Payment Integrity Services Team consisting of registered nurses. Working as an extension of your Patient Financial Services staff, our team handles your appeals using their working knowledge of various payer authorization requirements, medical criteria and protocols necessary to make the case for successful appeals. In addition to clinical experience, our team offers follow-up and support during the arbitration process as needed to overturn even difficult denied claims.
Want experts to appeal your denied claims? Let our staff review your business and apply our knowledge to your bottom line.
Contact UsFeatures
- Licensed InterQual Review Agency
- Professional, Experienced Payment Integrity Services Team
- Support Services Focused on Effective Appeals for Acute Care, Skilled Nursing, Mental Health and Substance Abuse Denied Claims
- Assistance to Legal Staff as Needed
Benefits
- Optimize Patient Financial Services Staff
- Receive Customized Reporting
- Fee Contingency-Based on Net Recovery Amount
- Reduce Claim Denial Rates
- Reduce Bad Debt Write-Offs
