Understanding the root causes of denials and appealing them when they occur is the first step in building an effective denial management program and recovering additional net revenue. By integrating 835DenialWare with OpportunityAnyWare, your organization is able to parse and translate all incoming raw 835 files to identify at-risk accounts through advanced reporting capabilities that standardize denial tracking, reporting, and trending information.
Additionally, 835DenialWare integrates seamlessly into our ARWare workflow management solution so organizations already utilizing the solution can incorporate and capitalize on all 835-specific data elements to build denial-driven work queues and denial-specific activity trees. With full 835DenialWare integration, organizations are enabled to better automate and manage the entire overturn process – yielding maximum net revenue improvement.
- Segment the 835 ANSI denial codes into categories and subcategories for quick identification of root cause issues and the associated department and services (e.g. root cause owner, resolution owner, actionable vs. not actionable, and clinical vs. technical vs. informational)
- Track denied charges at the individual charge level
- Monitor denied charges as a percent of total revenue
- Track overturn rates and the associated dollars with Streamline Health’s proprietary overturn algorithm
- Integrates with ARWare to automate, define, and manage the denial overturn process
- Integrates with OpportunityAnyWare to quickly and accurately identify the departments, services, and payors responsible for denying claims and the effectiveness at overturning those denials