Healthcare

AppealsPlus

Identify Root Cause, Visualize, Optimize and Manage Workflow

Denials and underpayments are defects in the revenue cycle that indicate a provider’s inability to comply with payer requirements or a payer’s inability to accurately pay a claim.

AppealsPlus provides process and workflow improvement in identifying and appealing these underpaid and denied claims. This web native tool automatically analyzes ERAs and applies rules to place suspect payments and denials in the appropriate work queues, while adapting to comply with your payer contracts and timelines.

The Denial Management Solution utilizes dashboards and key performance indicators to provide quantitative management where data is measured and used to drive improvement decisions. It uses Software as a Service (SaaS) technology for rapid deployment without capital expense, so return on investment is immediate.

AppealsPlus improves your denial management around these key areas:

  • Filtering – what denials are real and workable
  • Reporting on denial categories to help prevent future denials
  • Forms and letters – automation and standardization
  • Process library – automation and standardization for responses to specific denials
  • Payer table – centralized and updated
  • Staff productivity – track progress and results
  • Advanced reporting results and tracking by denial, payer and time

Our solution provides the mechanism for managing the complexity of the appeals process, allowing the process to evolve over time and emerge as a new leaner process based on simple rules and operational performance.

To learn more about AppealsPlus, contact us today at 800.860.4427 and read additional information here.

Request Information