Reducing Denials and Increasing Patient Care

With denials rising in frequency every year, it’s important to understand where denials are coming from and how they impact your patient experience. Administrative expenses for hospitals, medical practices and health agencies are approaching $360 billion dollars a year – most of which is billing related. The typical cost of reworking a denial is $25 per claim which totals about $4500 a year if you are processing 15 denied claims per month. That seems like a surmountable gap when broken down, but almost a third of practices are processing denials manually which can be a long and costly process.

Gain efficiency through every step of the healthcare revenue cycle with ImagineSoftware's RCM solutions. btnLearnMore orange

Denials happen for a number of reasons:

  • Terminated Coverage
  • Services not covered
  • Maximum benefit for service has not been met
  • Pre-Authorization required

With the technology available, it’s surprising that benefit eligibility is still at the top of the list for payer denials. Something as simple as checking benefit coverage is still wreaking havoc in administration workflow, and with a little time and effort it can be avoided all together. What if your system had the capability to automatically detect patient coverage, eligibility and benefit deductibles?

Having a competent and knowledgeable staff running your front desk is one of the most important things you could ever put in place. The first person your patients encounter tells them everything they need to know about your practice. Is your staff friendly? Are they familiar with your system and processes? Do they provide benefit verification and estimation upfront? These are all things that can ensure a visit goes smoothly and avoids costly after appointment expenses.

Every practice wants to see their office and staff be effective and productive, but sometimes this comes at the expense of your patient’s experience. With healthcare becoming a patient and consumer centric industry, it’s important that the weight of the patient’s decision to choose you as a practitioner stays top of mind. Having a system that provides transparent pricing helps promote patient-practice communication, trust, loyalty and satisfaction.

How would your patients feel knowing what their total out of pocket expenses would be before they stepped into an exam room?
Would they feel secure in their provider experience and walk out feeling valued as a patient and not just a number?

We think they would.

This is why ImagineSoftware’s solutions all work seamlessly together to create a better patient experience for your practice. When ImagineAITM, ImagineDiscoveryTM, and HonorCare® are employed in your office your patients discover that their coverage questions have been answered before their visit begins. You have the ability to uncover missing demographic details, find missing insurance coverage, estimate patient responsibility, and offer reasonable payment plans and options to ensure that not only are the bills paid – but your patients feel taken care of long after they’ve left your office.

If you practice needs help caring for your patients, get in touch with us today. We’d love to help you find the custom solution that fits your healthcare billing needs.

If you enjoyed this post, you'll love our email updates!

Receive content on industry topics, upcoming webinars, current healthcare trends, and more!