Billing Denial Management

Denial management will always be a necessary part of the medical billing process. At APS, we are constantly working to  resolve denied claims. Our investment in new technology, automation and tying them to improved processes is allowing this goal to be achieved.

We employ electronic edits to flag potential problems early and use scrubbers for improved “clean claims”. The result of these practices contribute to APS having more than 97% of claims submissions adjudicated by insurers on the first pass. This allows APS to maintain most accounts in the 0 to 30 day range of A/R.

Our custom ERADMM (Electronic Remittance Advice Denial Management Module) allows us to see trends, resolve provider/ payor issues quickly and track individual claims until adjudication.

APS claims submission process “Best Practices” (Independent Audit)

Cleaner Claims … fewer denials, re-filings and/or appeals.