Denial Management and Appeals Support
Denial Management and Appeals Support
At M&D Consulting we offer quarterly membership. Let us assist with the research needed to help get your complex claim denials overturned. The membership is Q&A coding assistance services offered per quarter. Membership includes coding assistance, billing and coding troubleshooting, billing and collecting questions and assistance with appeals and denials.
A robust denial management and appeals support strategy helps healthcare providers recover lost revenue, minimize future denials, and optimize reimbursement efficiency.
Key Steps in Denial Management:
- Identify and Categorize Denials – Track and analyze denial trends(e.g., medical necessity, coding errors, missing information).
- Root Cause Analysis- Determine the underlying reason for denials and implement corrective actions.
- Proactive Prevention- Train staff, conduct internal audits, and verify claims before submission to reduce future denials.
Appeals Support Process:
- Review Denied Claims- Carefully examine denial reasons and cross-check with medical records and payer policies.
- Gather Supporting Documentation- Provide necessary medical documentation, physician notes, and prior authorizations.
- Timely Resubmission / Appeals: Ensure appeals are filed within the payer’s deadlines to avoid missed reimbursement opportunities. Make sure the first appeal has all of the necessary information needed to overturn decision.