Denial Management Services with SA Care Consultancy
Let us convert your every denied claim into dollars.
Consult with the best Denial Management Team
Denial Management Services by SA Care Consultancy
AR Management has become extremely complicated. The evolution of payment plans, patient copayments, co-insurance arrangements, and more patients in high-deductible health plans have increased the complexity and ambiguity of payments. Doctors need a comprehensive strategy to help minimize reimbursement issues and accelerate cash flow.
AR Management has become extremely complicated. The evolution of payment plans, patient copayments, co-insurance arrangements, and more patients in high-deductible health plans have increased the complexity and ambiguity of payments. Doctors need a comprehensive strategy to help minimize reimbursement issues and accelerate cash flow.
Do you know Why it happens?
Denials can happen for various reasons but are most often the result of an incorrect bill or claim. When a health insurance company denies a claim, it can leave the provider responsible for the full cost of the services provided. Enforcement usually occurs because an insurer wants to return some of the money paid to the provider. Payment may have been made through a healthcare financial intermediary, such as an insurance company or Medicare.
A bill may also be denied if the professionals providing solutions are not medically appropriate. Denial management services in medical billing extend beyond medical care services. Denial of a health insurance claim can include insurance providers that won’t pay for things like devices, diagnostic tests, services that are not covered by the insurance, products that are not covered by the insurance, screening at a medical facility, or if the provider who receives the bill is not licensed, that isn’t licensed by a licensed entity.
Denial Management Process
Our experts at Stream RCM follow the below process for denial management:
Track status
Follow up with the insurance company to track the status of the claim.
Identify Denial Issues
We identify denied claim, analyze the reasons, and follow up with the insurance company to check if additional information is needed and address the issues.
Refile the claim
Track the status of the claim with the insurer and follow up till the claim is resolved. File appeals are needed.
Resolve the claim
Posting of denials and rebilling to the secondary insurance company, transferring the balance to the patient, write-off the amount, or sending the claim for processing.
What Are Most Common
Denial Issues in Medical Billing?
Denials can happen for various reasons but are most often the result of an incorrect bill or claim. When a health insurance company denies a claim, it can leave the provider responsible for the full cost of the services provided. Enforcement usually occurs because an insurer wants to return some of the money paid to the provider. Payment may have been made through a healthcare financial intermediary, such as an insurance company or Medicare.
Common Categories of Denial in Medical Billing
Why Choose us
- 100% HIPAA complaint process
- 98% claims payment on first submission
- Increased efficiency owing to certified coding team
- Continuous and rigorous follow ups on denied and pending claims
- Reduced staffing issues and operating costs
- You will save almost 70% on operating costs
- No headache of staff training or update
- Quick response and answers to any billing query
- Dedicated practice manager for every practice to ensure streamlined communication
- Shortest turnaround time and faster reimbursements Cycle management by billing specialists
Year Of Experience
Medical Specialties
Happy Clients
Stream RCMs efficiency
to reduce denials
Verify Patient Eligibility
Process Prior Authorization
Reduce Billing Mistakes
Ascertain Medical Necessity
Focus on Getting Claim Resolved
OUR CUSTOMERS THOUGHTS
Deanna Windham
"SA Care Consultancy has been a lifesaver! They took over all our time-consuming administrative tasks, freeing us up to focus on growing our business, Their services are efficient and accurate, allowing us to trust that our daily operations are in good hands, Since partnering with SA Care Consultancy, we've seen a significant improvement in our team's productivity."
Sarah Jackson
"SA Care Consultancy is a reliable and trustworthy partner. They truly understand our business needs and deliver exceptional results
Their commitment to customer satisfaction is unmatched. They go above and beyond to ensure we're happy with their services. I highly recommended them"
Adam Smith
"SA Care Consultancy's team of medical billing experts has been a game-changer for our practice. They take care of all the complexities, ensuring accurate VOBs and timely claim submissions. It's a huge relief knowing our billing is in their capable hands, and it's allowed us to significantly reduce the stress associated with medical billing. they can be your best billing partner"
Deanna Windham
"The entire team at SA Care Consultancy are really awesome!" They are highly trained, very effective, patient with lots of questions and have helped me to improve my reimbursements significantly. I highly recommend SA Care Consultancy to any business looking to streamline operations, achieve growth, or improve their medical billing process."
Sarah Jackson
"I was initially hesitant to trust a new company, but SA Care Consultancy quickly put my worries to rest. Their team is incredibly knowledgeable and always explain everything clearly. Since partnering with them, we've seen a noticeable improvement in our revenue. Being a new company, SA Care Consultancy has provided a level of invaluable trust and reliability. I wouldn't hesitate to recommend them to anyone looking for a trustworthy and efficient medical billing solution."
Adam Smith
" They're more than just medical billing wizards they handle everything from website, marketing to customer support and even those pesky admin tasks. It's like having a whole extra dedicated team. thanks to their efforts our front desk staff can now focus on patients instead of paperwork. If you're looking to streamline operations, free up your team to focus on what matters most, SA Care Consultancy is the answer"
Reliable Convenience for all
your medical billing and RCM hassles
With SA Care Consultancy, you can conveniently stay connected from anywhere in the world and get access to all your medical related information including patient appointment scheduling, patient treatment plans and reports, scheduling updates etc. SA Care Consultancy allows you to establish a profound relationship with your patient, which is trustworthy and reliable, just as SA Care Consultancy is committed for your medical billing solutions.
Strategy and Planning
We bring the right people together to challenge established thinking and drive transform. Don't just manage billing, chart your practice's success with SA Care Consultancy. Our planning tools help you analyze data, optimize workflows, and set achievable goals.
Better Interoperability
All your medical billing workflows will synchronize easily to give you extensive information and data analytics on all your medical revenues, patient information and billing processes.
Real-time Intelligence
All your medical billing processes and workflows are automated to provide real-time information that is accurate and 100% error-free.
Frequently Asked Questions About
Denial Management Services
How long does the credentialing process take?
Turnaround time varies between insurance carriers, so there is no one answer to this question. Major carriers generally take between 90-120 days to complete the process. Smaller carriers and insurance plans may take longer.
Upon submitting a participation request to a commercial carrier, providers will need to undergo two processes. The first of these is credentialing, where the carrier verifies all provided credentials and presents them to their committee for approval. Once providers are approved by the credentialing committee, they are then directed towards the contracting process wherein their participation is approved, and they are provided their effective date.
Commercial carriers do not allow for retroactive billing, meaning providers will only be compensated for claims submitted after they are listed as an “In-Network” provider in the carrier claims system. Out of network billing will result in much larger bills for patients and patients may be responsible for the entire bill on their own.
How long does it take to enroll with Medicare?
Applications of enrollment in Medicare typically take between 60-90 days to complete, though this does vary wildly between states. The effective date for Medicare is set as the date the application was received, allowing for providers to retroactively bill for any encounters that occurred between application and approval. There is also a 30-day grace period, enabling providers to bill for service provided up to 30 days prior to their effective date.
Turnaround time is longer for DMEPOS suppliers. In addition to the close scrutiny that every application is subjected, suppliers will also be required to participate in a site visit as part of the application process. The site inspector will be responsible for ensuring the office is located at the address included on the application, as well as hours of operation, where inventory is stored, and other important elements of being a DME supplier.
Can Sa Care Consultancy make the credentialing process quicker?
Sadly, Sa Care Consultancy cannot make the process any quicker. Our contribution is efficiently and effectively managing the entire application process, beginning with initial credentialing applications and carrying through to follow-ups with carriers. Our experts are well versed in the entire process, saving time that might otherwise have been wasted by providers attempting to perform the process themselves and making mistakes along the way.
Do I need a service location to begin credentialing?
Yes, it is necessary for providers to have a place of service before they begin the medical credentialing and contracting process. A home address cannot be used as a clinic address, wither permanently or temporarily. A home address can, however, be used as an address for billing or correspondence, but only if a physical address for the practice is also provided. In the event that the office space is still under construction, the address can still be used. The application can be sent up to 30 days prior to the location actually opening up to patients, and most commercial carriers also offer the same guideline.
How do I complete Medicare Revalidation?
Revalidation of Medicare enrollment is required every 5 years but DMEPOS suppliers revalidate every 3 years. Individual providers can either complete the CMS855I paper application or use PECOS to complete the revalidation online. For groups or suppliers, the CMS855B application must be completed. If an Electronic Funds Transfer was not previously set up for the group record, one will need to be created for the revalidation process.
Providers mus