This article is initially available on our podcast. Click here to listen.

We have an opportunity for a limited number of entities to try out one of our new modules. We’re offering this for free as a beta test. If you’re interested in applying to test it out, don’t hesitate to get in touch with us.

Denials routing

I’ll tell you briefly about what this one is. It’s a denials management module. We’ve talked about denials management in a lot of our podcasts and blog articles. There are several other denials management modules. One of them is what we call denials routing.

What it essentially does is it takes all the data from a system and extracts the denial information out of the system (either from a clearinghouse, from your system itself, from reports, from whatever that might be) even if it’s complete garbage. We can pull that information out of that, clean it up, identify what those codes are, the denial reasons attached to it. We can group those codes.

Route to the right department

For example, suppose it’s a medical necessity or something else. In that case, we can route them to all kinds of different departments, meaning denial codes that should go to appeals or should go to your payment posting department or that should go to coding or medical records or whoever does problem-solving, research, patient demographics. It takes all of that information for all of those denials. It then appends a bunch of data after it cleans up that and then routes those to the correct department to have them worked so that you can get those denials paid.

The primary benefit that we’ve seen so far is that it provides some significant cost savings because we’ve seen billers be more productive. That means that you can either get a lot more claims worked, which means you can increase collections, or, in some cases, they’ve reassigned individuals in specific departments, meaning they’ve lowered their costs. They’ve brought those into new clients, so they haven’t had to hire as many people, for example. So either cost savings or increased collection rates, meaning more revenue and, therefore, better profitability.

Learn the concept

We’ve also seen we add this function because billers and collectors have a lot fewer questions on what to do with the denials. After all, a particular list comes to them that says, “Hey, here are the ones you’re supposed to do X with. And here are the ones you’re supposed to do Y with.” Only the ones that they’re supposed to work come to them, so they don’t have to fish through giant lists. It means that there are a lot fewer questions that those people have for managers and supervisors. So it has taken a significant burden off of the management team.

In conclusion

We’re offering this as part of a denials management package to a select number of entities, billing companies, health care providers for free. If you’re interested in trying this out and you’d like to do it, there’s no cost to do so, but you do have to apply. There are some requirements to doing it, and there’s a limited number of slots. So if you’d like to give it a try and see if you qualify, contact us. My email address is smcsweeney@apachehealth.net. Let us know if you’re interested, and we’ll get you on the other side.