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Jump to:
Categories
Solutions
Description
Compatibility Level
Clients
Use cases
EHR integrations
Client types
Differentiators
Keywords
Media
Company details

Categories

Solutions

Description

Product Description:
MedData’s Denials Management Outsourcing Services improves your business office’s effectiveness by allowing it to concentrate on areas of the revenue-generating process that have a higher yield and do not distract hospital account representatives from their primary duties. We have dedicated specialists who focus on denials management nationwide with extensive experience working with ALL payer types, scenarios and denial reasons. MedData provides invaluable feedback to help the hospital improve its approach to the denial management process. We provide reports on a monthly basis (or as needed) that track payer, denial type, service, and physician’s issues. This helps our clients improve their internal processes that in turn will lead to long-lasting gains in Accounts Receivable performance. MedData works all denial types including: • Lack of Authorization • Insufficient Authorization • Medical Necessity • Unresponsive Recoupments • Coverage Exclusions • Pre-existing Condition • Coordination of Benefits • Timely Filing • Subrogation\Accident Details • All Denial types (administrative/clinical) MedData also has a dedicated focus on unresponsive patient denials (UPDs), which consist of any denial type where the patient’s and/or subscriber’s involvement is required in order to secure resolution on the claim. Our service helps prevent these denials from getting lost in self-pay and ending up in bad debt. UPDs include, but are not limited to: • Coordination of Benefits (COB) • Pre-existing questionnaires • Incident letters • Accident letters • Adding newborns to policies • Subrogation forms • Authorizations • Any other time a patient’s involvement is required by the insurer The benefits of utilizing MedData to perform your denials management is that we have the following performance drivers: • Dedicated RNs on staff for medical necessity reviews, peer to peer coordination, etc. • Primary focus on Commercial and Medicare/Medicaid claims • Strategic focus and prioritization based on dollar balance and/or potential reimbursement, age, and timely filing requirements • OCR capabilities for digitalization of hard copy remits/EOBs • Dedicated compliance team and internal legal resource with nationwide legal partnerships • We aggressively work the account until it is 100% resolved • Complete “feedback loop” to prevent future denials through a rigorous root cause analysis process • Close coordination with contracting department to ensure compliance and provide insight for future contracting • Overturn denials through the appeal processes when necessary • Incoming and outgoing call campaign with the patient • Patient texting capability • Streamlined patient letter series • Skip trace with three levels of escalation
About MedData:

MedData has been a tenured and trusted healthcare revenue cycle management services provider for more than 40 years, delivering technology-enabled and patient-focused RCM solutions, including Eligibility & Disability, Accounts Receivable Services (ARS), Injury Accounts (Workers’ Comp, Auto, etc.), Veterans Administration, Patient Responsibility/Early Out, COB Denials, and Out-of-State Eligibility. MedData has patient advocates from coast to coast and experience with hospitals and health systems of all types – large to small, rural to urban, nonprofit to for-profit – giving the company a nationwide presence with a local feel that’s scalable to any volume. Click the "Files" tab for downloadable content with more information about our organization.

Product Description:
Denials Workflow Manager product features: - Standalone or integrated: Can be used as standalone product, or integrated with Experian ClaimSource to align claims and denials information on the same screens. - Customizable: Work lists generated based on client specifications, such as denial category and dollar amount. - Analytics: Access standard product reports, analytics reports, and forward responses to HIS/PMS systems. - ANSI reason codes: Provides ANSI reason codes and payer proprietary codes as well as descriptions.
About Experian Health:
Experian is a global information services company that provides information, analytical tools, and marketing services to help clients manage their commercial and financial decisions. The company helps organizations manage credit risk, prevent fraud, target marketing offers, and automate decision making. It also enables individuals to check their credit report and credit score as well as protect against identity theft. The company is listed on the London Stock Exchange (EXPN) and is a constituent of the FTSE 100 index. Experian was co-founded by Michael A Barron and Bernie Brenner in January 1980 and has its corporate headquarters in Dublin, Ireland, with operational headquarters in Nottingham, United Kingdom; California, United States; and São Paulo, Brazil.

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EHR Integrations

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Client Types

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Company Details

Founded in 1980

Founded in 1980

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