Clinical Appeals Management
Medical Coding Consultants and Healthcare Revenue Cycle Management Consulting
We manage every step of the appeals process to recover revenue lost to inappropriate denials.
Clinical Appeals Management is a critical component of hospital revenue integrity strategy. We assist you by ensuring you receive accurate reimbursement for the services you provide through the identification, management and education required to improve claims recovery efforts.
Experienced Appeals Specialists
When it comes to the appeals management of clinical denials, knowledge is key to resolving and overturning claim denials. Our clinical appeals team of Registered Nurses (RNs) and Compliance specialists are employed on-shore, and have an average of over 20 years of experience. They hold multiple of the following credentials: RN, CCS, CDI, LNCC, C-DAM, CCS-P, CDIP, CCDS, RHIA, RHIT and various audit and compliance credentials.
Having an in-depth understanding of payer specific medical policies, healthcare statutes and national guidelines, our specialists thoroughly review denied claims, write an expertly written appeals letter, and provide insight and strategies to prevent future avoidable denials.
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What People Are Saying About Us
The Managed Resources clinical appeals team have been excellent to us! Not only in having such a positive impact in recovering appropriate reimbursement for denials, but for their personal and timely approach to sharing educational tools with us to help prevent future denials. They really provided us with a high quality of service.
I can honestly and without hesitation declare these to be the absolute finest, most thorough, comprehensive and convincing clinical appeal letters I have ever seen in my 25+ year career as a hospital revenue cycle leader.
CodingAID has worked with our physicians to provide valuable and timely coding and documentation education
Thank You, Thank You!! I found myself in a huge bind. Inpatient and outpatients accounts in backlog. Reaching out to you saved me. Not only did they provide High Quality Experienced coders, they got my backlog under control/caught up in no time.
We were really pleased with attention to detail that was provided to us in the review of clinical appeals management and charge capture It was clear to see that your team knew what they were doing!