Jacobus Consulting
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Cash Acceleration Services - Denials Management Program
Denials Management projects involve:
- Analyzing root-cause denials from EOBs and RAs, including process analysis of denials entry points and denials processing practices for billing, cash posting, insurance follow-up, correspondence, Case Management/Utilization Review and other identified areas as necessary.
- Establishing a “Denials Task Force” to stop denials at their root causes.
- Making recommendations for system and workflow optimizations.
- Implementing a Denials Management tracking database to establish visibility and control over technical and clinical denials, whether electronic from payor or in paper correspondence. This includes full denial management trending and reporting.
- Providing training of personnel in Denials Management best practices.
- Recovering cash by providing experts familiar with payor guidelines who are knowledgeable in aggressive denials appeal techniques and turnaround strategies.
DMC – Denials Management Database Software System
Jacobus has developed an easy to implement Denials Management database system called DMC. Built on SQL and utilizing custom Jacobus code, DMC integrates information from disparate systems - whether electronic or in paper correspondence - into an automated workflow solution that integrates clinical and technical denials to provide complete tending, tracking, reporting and denials follow up assignment.
The benefits of a Jacobus Denials Management project include:
- Improved collections from recovered appeals for claims nearing timeliness deadlines and through consistent working of appeals.
- Collaboration between Business Office and Case Management personnel.
- Education of Business Office personnel on advanced strategies for improved denials management.
- Establishment of complete visibility and control for better coordination, monitoring and reporting of denials status information to management.
