Denial Management Program

Avoid the avoidable

Take control of the claims process. Once you can identify and eliminate the root causes of denials, you’ll be able to truly increase cash collection and maximize reimbursement.

With Denial Management Program from TruBridge®, you can avoid denials in the first place. This program’s customizable, three-step approach greatly reduces delays in payments, lost revenue and decreased patient satisfaction associated with denials.

Claim denials are expensive. Average costs of remediation through appeal:¹
       $118 PER CLAIM

¹Philip Betbeze, “Claims Appeals Cost Hospitals Up to $8.6B Annually,” HealthLeaders, June 26, 2017

Set your hospital up for success with the comprehensive Denial Management Program from TruBridge.

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STEP 1 Analyze, Prioritize, Report

Gain valuable insight from an electronic analysis of your 835 remittance and 837 claims data. We’ll categorize and prioritize denials into key areas, including the number of claims and the corresponding revenue opportunity, plus report inclusive data.

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STEP 2 Onsite Assessment and Remediation

Discover the root causes behind denied claims with detailed review of your current workflows, from patient registration through claims submission. We’ll help you automate the process, implement best practices and re-engineer workflows so you can avoid these denials in the future.

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STEP 3 Ongoing Surveillance and Tracking

Keep things moving in the right direction with continued monitoring. Together we’ll ensure the root causes of denials have been resolved and finetune workflow modifications using trend reporting and data analytics as necessary.

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Denial complexities cost $265.6 billion

Learn about the new process for measuring outcomes of denials management efforts, including key performance indicators (KPIs), established by the HFMA Claim Integrity Task Force.

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90% of denials can be prevented

Gain a better understanding of what corrective actions can be put in place, including best practices and key metrics.

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