Denial Prevention

Life of a claimDenial Prevention: Based on our experience working with physicians and healthcare organizations we understand that the revenue cycle success starts at the patient registration and continues throughout the claims cycle. Accuracy of patient demographics and financial information upfront results in reduced denials, fewer rejected claims, and fewer returned statements. Claim cleanliness is the key component that stops the denial from origination, and it is impacted by the following parameters:

  • Patient registration data quality
  • Prior-authorizations
  • Non-covered services and medical necessity management
  • Eligibility and benefits coverage
  • Clinical documentation quality
  • Coding
  • Claim editing
  • Payer rules & mandates

The ebix, Inc. team supports your healthcare organization with denial prevention capabilities and best practices. We assist you in identifying root causes for errors in the front end of your revenue cycle, which therefore improves the downstream process. In addition, we help in checking the medical necessity requirements and the creation of necessary ABNs, resulting in reduced denials and faster payments.

claim works

Experienced Billing Services gets you more with Denial Prevention 

It is essential to realize that the key to successful Revenue Cycle Management is understanding all your practice’s revenue sources. Hence, our team will help improve profitability by monitoring, measuring, and managing all aspects of your revenue cycle.

Indeed, the ebix team has excellent tools and experience. Hence, our Revenue Cycle Management solutions are in place to capture revenue from claims remittances, patients, and evidence-based data. Collecting from all these sources will help secure your practice’s health care payments and enable it to become more profitable.

Medical Coding Compliance

The ebix team has a strong reputation as an expert in medical coding service. By and large, medical billing begins with accurate and complete documentation in the medical record.  Hence, coding is the way your intellectual services and labor translate into a code used to bill insurance and document the value of your service.

Perhaps most noteworthy are the ICD-10 codes. The ICD-10 codes are currently the cornerstone of classifying diseases, injuries, health encounters, and inpatient procedures in morbidity settings. Because of this, the ebix, Inc. team has honed medical coding skills and business processes to meet the needs of independent physicians.

Therefore, the transforming of a provider’s narrative or description of the disease, injury, and procedures into universal medical code numbers for the insurance claim is the fundamental purpose of medical coding. For this reason, our team of professional certified medical coders ensures higher reimbursement by properly aligning services with a medical diagnosis. Consequently, this doesn’t just assure proper payment. It will also minimize denials resulting from the incorrect association of diagnosis and procedure codes.