Improve denial management in healthcare
On the surface, your practice is thriving. But when you take a closer look, your monthly revenue reports tell a different story.
It could be something as simple — and frustrating — as a missing payer ID, or an invalid diagnosis code.
But it happens. A lot. And if you aren’t taking steps to protect yourself against claim rejections through improved denial management, it could mean the difference between thriving financially and, well, struggling to keep your doors open.
That’s where a clearinghouse service can help.
How can a healthcare clearinghouse improve denial management?
Denial management in healthcare is key to any practice's revenue cycle management success. A clearinghouse uses software to send and receive electronic claim and financial information to insurance carriers securely to safeguard Protected Health Information. The clearinghouse allows your billers and billing managers to consolidate and manage all electronic claims from a single location, such as an online dashboard or portal.
Healthcare clearinghouse services allow you to better manage the full claim cycle with financial, clinical, and administrative electronic data interchange (EDI) services with technology that’s fully integrated with your practice management system. Clearinghouse services also offer convenience. In addition to being able to electronically submit claims to thousands of insurers, you can receive electronic remittance advice reports, verify insurance eligibility, send electronic prescriptions, and more. This integrated solution provides your practice with greater control and visibility into the claims lifecycle, which is crucial for practice health.
Basically, you’ll avoid claims headaches and you’ll get paid faster. That’s been Jill Coale’s experience. “We had a lot of bad claims that were just sitting with our other clearinghouse,” practice manager for Sawyer Surgical Clinic said. “With the Greenway Clearinghouse, we're getting dirty claims back a lot faster.”
Check out the webinar, Top 10 claim mistakes and how to correct them, to learn how these common errors can be fixed before submitting claims to a clearinghouse.
Top benefits of a clearinghouse
- Manage claims, ERAs, and payer data from a single location.
- Catch and fix claims almost instantaneously to improve clean claims rate.
- Submit a batch of claims and/or eligibility verification rather than individual filing.
- Reduce manual processes and speed up turnaround time.
Healthcare denial management questions you should ask a clearinghouse vendor
If your practice is considering using a clearinghouse, it’s important to find the vendor that fits your needs. Here are some questions to consider asking a clearinghouse vendor. If they can’t answer these questions with a “yes” or with satisfactory detail, it might be time to move on to the next vendor on your list.
- Do you provide an automated system for electronic eligibility, claim status, and notification transactions?
- Do you file secondary claims electronically?
- Is your system fully integrated with practice management platforms?
- Can you handle electronic remittance statements and electronic funds transfers?
- Does your system automatically post payments?
It’s important that the clearinghouse you select can provide a full support team to resolve all your connectivity and revenue cycle questions, concerns, and challenges. This will help you better manage financial and transactional data so you can get paid what you deserve as quickly as possible.
Here's a short video that can help you determine if you’re bringing in every dollar you’re owed.
If getting paid quickly is a priority for your practice, then having a clearinghouse service to make that happen should be a priority, too.
Click here to read more about revenue cycle management and the role of a clearinghouse.
For more information, click here to schedule a conversation with a Greenway representative.
Additional Resources
GRS Lunch & Learn series - An up-close look at eligibility
GRS Lunch & Learn series - Optimizing the front office for revenue cycle success
GRS Lunch & Learn: Billing the backlog
