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Multi-Payer Audits & Denials

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Let us handle all the legwork.

Our Multi-Payer Audits & Denials tool is your go-to solution for submitting, tracking and analyzing claims as they make their way through the revenue cycle. It streamlines HIPAA-compliant, electronic submission of medical records and automatically drives your workflow while providing business intelligence through superior reporting and analytics. This solution also makes the claim appeals process exponentially more effective.

This solution ensures you get the money you deserve as quickly as possible. Healthcare providers oftentimes are forced to write off denied claims when the appeals process becomes too time-consuming or because they lack the required staff resources to dedicate to the task. Our Audits & Denials solution is critical for any organization wanting to increase workflow effectiveness and recover payment from denied claims.

Key Features and Benefits
  • Improved management reporting and analysis
    Track the status of your claims and identify the source of rejections and denials automatically. Stay on top of deadlines and boost your chances of a successful appeal.

  • Respond to audit requirements faster
    Send and receive documents requested by RAC, MAC, PERM, CERT, ZPIC and SMRC audits with our secure, HIPAA-compliant esMD gateway service.

  • Appeals management that puts you in control

    Enhance your process with integrated appeal notes, workflow support/follow-up and unlimited users.

  • Reduced/prevented denials and rejected claims
    Quickly and easily assess reasons for denials and rejections. Ensure your team is on top of every ADR or appeal requiring action with automated entry of staff work lists.

  • Reduced labor costs

    Stop wasting time chasing paper. Multi-Payer Audits & Denials automates the appeal process.

  • Follow full audit trails

    In-depth ADR tracking helps you pin down the claim’s exact status and location in the Medicare FISS system. 

  • Streamline your electronic document submission

    Use esMD to electronically transmit RAC, ADRs, PA, and Reconsideration Appeals documents through our secure, HIPAA-compliant gateway.

  • Improve management related to post-pay reviews

    Manage the entire audit trail of a post-pay review. Keep track of your contacts, generate and attach documents, route the claim and request follow-up.

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