Maximize Revenue Potential

Maximize revenue potential by vetting data using proven data mining techniques…

Problem: A large healthcare provider needs to understand why payment is being denied on many of its insurance claims. The billing process is complex and the number of denied claims exceed 1,000 annually. Ultimately, understanding the reasons will allow the provider to correct some of the previously denied claims and re-submit for payment.

Solution: A thorough vetting of all claims data using proven data mining methods; identifying patterns in the denied claims, producing an executive “decision making” summary report of all denial reasons, (including frequency and financial impact of each) , and fixing the previously denied claims to allow for re-billing.