Denial & Appeals Management

Despite our diligent efforts to put processes in place to prevent denials, some denials still happen. The time-consuming process of denial management, which includes tracking claim adjudication, identifying zero-paid and partially paid claims, researching reasons for denials, collecting necessary documentation, and writing and submitting appeals, need not be so laborious.

TriumpHealth’s denial management team combines people, process, and technology to drive denial prevention and identify the root causes of denials throughout the revenue cycle. We target high-impact denials by type and recommend process improvements to prevent denials that adversely impact cash flow.

Depending on the denial category, we task accounts to the appropriate staff member e.g. TriumpHealth coding, billing, and medical records staff, or practice front office, clinical, and administration staff when key performance indicators fall outside target ranges. We analyze denials per CPT, and per payer to drive root cause analysis. We auto-populate payer and CPT specific templates along with all necessary paperwork for payer appeals. Our staff also mails appeals and any associated attachments on your behalf, and then we follow up on them till adjudication.

To learn how TriumpHealth can significantly improve your denial management and collections, contact us!