Providers need a way to identify high-dollar procedures that may be impacting their bottom line and causing them to stand out to payers. By leveraging comparative data along with the practice’s internal practice management systems, the provider now has a checks and balances system to reduce the risk of denials.
Healthcare providers need a method to compare data to peers to improve business operations and prioritize initiatives. Using TITAN, practices can compare data to peers and identify areas needing improvement.
Leveraging comparative healthcare analytics, the provider created a report identifying all denials by payer for a specific time period. They were able to filter the denials by the CO4 adjustment code with modifiers 26 or 91.
Comparative analytics can help providers determine if they are consistently coding for
higher-level reimbursement than their peers, in turn reducing the risk of a Medicare audit.
TITAN's performance insights can help providers trend billed service lines billed to a specific payer, helping pinpoint and reduce spikes in billing and denials.
Today’s large clinical reference laboratories, like Clinical Laboratories of Hawaii, LLC, face several revenue cycle challenges, from changing regulations and declining reimbursement, to tracking a large volume of claims – many of which are for small dollar amounts. After implementing eSolutions’ TITAN, the organization was able to thoroughly analyze claim rejections and denials and make quick improvements, resulting in a $200,000 increase in net revenue in just a two-month time period.
Like many medical billing companies, Enhanced Revenue Solutions (ERS) struggled to keep up with changing regulations and payer reimbursement rules that often occur without notice. They turned to eSolutions’ TITAN to help them more efficiently work with healthcare providers. TITAN helped ERS quickly identify client problems with real-time, transparent insights. ERS has helped providers across many states and specialties pinpoint issues causing denied and rejected claims.