Medical claims denials are a frustrating reality for healthcare organizations. They slow down reimbursement, lead to revenue leakage, and require valuable effort that could be better directed toward providing exceptional patient care.
Exela has developed a comprehensive denials management system that streamlines every step in the process, from intake to appeals, to trend identification - all to maximize operational efficiencies and optimize reimbursements.
Reduction in Denials and Rejections
of effort reduction on downstream tasks
Turn around Times
Intuitive Categorization for Streamlined Action
Accurate automated classification of denials based on the reason and remark codes. Batch claims to take immediate action on claims with similar issues.
Insightful Reporting for Continuous Improvement
Analyze denials by payer, provider, claim category, claim type, and a variety of other metrics to identify trends, inform decisions and empower strategic process improvement.
Convenient and Effective Appeals Templates
Increase the chance of recovery while speeding up the appeals process with configurable inbuilt appeals letter templates.
Denials Management is one part of a robust approach to Revenue Integrity that not only identifies claims that need to be resubmitted and/or appealed, but also uses root cause analysis to proactively prevent future underpayments
Leverage advanced digitization tools and smart systems powered by AI and machine learning to automatically classify claims, extract data, and route of claims for patient/third party collection & submission of claims to the right payer/secondary payer.