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Prevent Claim Denials and Manage Appeals Like a Pro

Denials can hit your healthcare organization where it hurts.  According to MGMA, the average denial rate of a physician practice ranges from five to 10 percent. The median 350-bed hospital saw average write-offs from denials rise to $7 million in 2017.

Targeted Probe and Educate: What to Expect

The Centers for Medicare and Medicaid Services (CMS) announced Aug. 14, 2017 that it will expand on its Probe and Educate program, which initially began in 2014 as a national clinical documentation review strategy to reduce and prevent improper payments. CMS believes the results of the program have been positive, as providers that received education experienced a decrease in claim errors.

On a Scale of 1-10, How Are You Feeling?

Are you knee deep in audit responses, processing denied claims, or manually uploading to CMS? Tired of keeping up with changing healthcare regulations? We get it!

In the healthcare business, you know what you do ultimately helps other people feel better. But what about YOU? Check out our new eSolutions video to learn just how our custom analytics and workflow products help you feel less pain and more gain.

Manage Denials with the Dynamic Duo

Are denied claims wreaking havoc on your cash flow? If left unchecked, these denials can slow down your entire reimbursement process. Fortunately,  Audits & Denials is here to help.

Update on CMS Recovery Audit Program and RAC Audits

Sign up for our free webinar to learn the latest on the Recovery Audit Program and RAC Audits.

eSolutions is pleased to present Brian Elza, Director of the Division of Recovery Audit Operations (Provider Compliance Group/Office of Financial Management) at the Centers for Medicare & Medicaid Services (CMS).  Mr. Elza will discuss the recent developments in the Recovery Audit Program. Join us on Wednesday, March 25 at 1 PM CST for this informative and interactive presentation.

Redetermination Requests Now Accepted Through esMD

MACs JK (NGS) and J6 (NGS) are now accepting Level 1 appeal (Redetermination) requests through esMD.  A Redetermination request is a request for re-examination of the initial claim decision. It is conducted by the MAC or DME MAC.