Denial Management and Appeals

Research shows that denied claims can account for up to 10% of monthly claim value. Researching and resolving denied claims can cost as much as 145% more to collect than clean claims due to manual processes and lack of technology. NHPN has created an effective denial management program which identifies the root causes of denials and develops custom solutions to correct the problems.

Efficiently recover revenue due to clinical and technical denials.

• Experienced managed care experts to over-turn clinical denials
• Software tool groups payer denials to allow bulk appeals
• Detailed reporting on the source of denials by payor, physician, DRG and how to remediate
• Efficient tracking and reporting of appealed claims including overturn rate by category of denial
• NHPN paid on contingency fee basis providing a risk free service offering
• Leverage the extensive national managed care expertise of NHPN for best practice solutions in contract language and management