It’s time to stop managing denials and start preventing them.

Mistakes made during the patient registration process leave unrealized net revenue on the table. Even a single-digit denial rate still results in tens of thousands of denied claims annually for large health systems. Denials are a persistent problem, with up to 1 in 5 claims delayed or denied. All of these medical claims have to be reworked or appealed. Reworking them costs an average of $25 per claim.

Your denials management process may imply denials are coming from the clinical side, but more often they’re the result of registration information not being processed correctly. The top four areas causing first pass denials are:

Up to 70% of all denials are front-end-caused and very predictable, and therefore, are preventable—if the registrar is alerted to each payment risk and given guidance to resolve it prior to service. AccuReg audits and alerts front-end staff at four opportunity points: ordering, scheduling, patient arrival, and registration.

70%

Up to 70% of all denials are front-end-caused, very predictable, and preventable

Most hospitals’ top denial cause is eligibility-related, despite having a real-time eligibility (RTE) system. AccuReg goes beyond RTE, by auditing every account based on known denial patterns and each facility’s unique payer rules. This is what sets us apart. Without intelligence-driven auditing and individual registrar accountability, RTE is just data. We turn it into Front-End Payment Intelligence™.

Check Out Our Solutions for Eliminating Denials Before They Happen:

    What AccuReg Denials Prevention Gives You:

    • Embedded training based on individual patterns. Powered by artificial intelligence, our software continually learns registrars’ performance and error patterns and recommends training “on the fly” to improve performance.
    • Intelligent guided registration with tailored scripts to guide the registrar through tricky or sensitive situations. Registrars will know what to say, when to say it and how to say it.
    • Standardized process automation that auto-corrects subscriber data from the payer without user intervention.
    • Registration Quality Assurance (QA) that sends escalation alerts to supervisors. This allows for intervention prior to submitting a claim, reducing errors prior to submittal.
    • Failure escalation that means if an authorization code is not obtained, an alert is sent to the registrar and the supervisor. Supervisors get involved at registration rather than at collection.
    • Individual accountability tracking that tracks all unresolved issues in individual performance metrics. The result? Performance improves. Weaker players are coached as needed or weeded out.

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