PrognoCIS - Your Denial Management System  

Efficient Denial Management to Boost Your Bottom Line

Exceptional Analytics

Our team offers exceptional analytics to improve your outcomes. We handle the appeals process to streamline every step so that your organization gets paid in full, in the shortest amount of time.

Task Management

Denials cost your organization time and money. Eliminate the waste in your revenue collection by delegating this exceptionally important task to a seasoned team ready to help your business thrive.

Claim Management Specialists

Highly trained specialists improves your appeal processes and lower your denial rates enhancing your healthcare organization's collections process.

Improved Claim Management Process

An effective claims management process means improved revenue cycle management. We have experts who have a wealth of experience in all facets of claims management. This means that your process is improved from the beginning to ensure an immediate decrease in your denial rates.

Lower denial rate

How PrognoCIS Lowers Your Denial Rate

➤  We specialize in working with your analytics to understand the intricacies of your claims process.

➤  We can pinpoint areas where a denied claim may be an issue. This means that we can proactively correct your process, so your denial rate is lower.

➤ In the cases of a denied claim, our experienced staff brings a wealth of expertise to the appeals process to make sure that your claims are paid by the insurance carrier, in full.

➤   We take the red tape out of the process for your practice so that you can concentrate on patient care while we make sure that your revenue management runs smoothly.  

Ready to take your Practice to the next level?

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Denial Management Service Highlights  

At PrognoCIS, we optimize your Revenue cycle so that you see reduced denials and a shorter payment cycle. Here are some of our benefits:  

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Reduced Labor

Lighten your staff's work and take the help of a team that can accomplish the task in a shorter time frame.

Functionality

With advanced technology, you get a user-friendly solution that gives your team full oversight.

Robust Analytics

With in-depth data, you immediately see improvements in your claim management.

Claim Alerts

Using PrognoCIS EHR, you get claim alerts to keep you up to date with all your claims.

What does PrognoCIS Offers

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Denial management services are managed by our medical billing specialists. You get professional help to analyze your revenue management and finally enhance your practice's return on investment.

We offer 24/7 service that takes care of denial prevention, claim analysis, financial planning, AR management, and trend analysis. With this robust coverage, we make sure that you have decreased denied and unpaid claims and your reimbursements are timely.

Ready to take your Practice to the next level?

Benefits To

➤   Claims management and the appeals process are precise and can become complex without the right experience and analytics to streamline the process.

➤   For our providers, PrognoCIS provides a worry-free solution, clients can rest assured that their claims will be handled accurately and efficiently.  This frees up your staff’s time to work with the patient care that’s primary to your organization’s mission.

➤   It also alleviates strain from employees who don’t work solely with denial management, trusting this task to a staff that is well-trained in the process and less likely to encounter difficulties or errors.

Testimonials

What People Say

"I have been very pleased with the service I get regarding my billing with PrognoCIS. The team I am assigned with is wonderful! We communicate daily, we work together, all of my questions are answered and problems solved in a timely manner and we continuously work on strategies to make the process more efficient. I could not be more pleased and would highly recommend them to all of my colleagues."
"The team is very reliable and transparent in their billing activities. Denials are worked on to the best they could. Our billing manager, Dawn, always addressed any questions or concerns that we have. We communicate with her on a regular basis. Highly recommend Prognocis RCM."

More Testimonials

FAQs

Denial management is the process to analyze your claims and understand why they were denied. This is an intricate process that uses advanced analytical tools to see overall trends in claim management and for individual insurance carriers.

Once the data is assessed, the denial management team improves the process to mitigate risks in the future.

For an optimal denial management process, your organization needs to investigate each denial and claim process. This process can be tedious and time-consuming without the right experience and tools. By fully analyzing the process, you can determine strengths and weaknesses. You also need to pinpoint individual trends based on individual payers to ensure that your risk management is precise.  

We streamline your workflow so that your organization can stay on top of your revenue cycle management. Without an efficient process, your practice is at risk of losing revenue every year due to inaccurate claim management and faulty appeals processes.  

The goal is to improve the claims and appeals process, which improves the organization’s revenue cycle management. The aim is in reducing denial rates and increasing cash flow.  

There are several types of denials. They include:

  • Claims not covered by the insurance payer
  • Duplicate claims
  • Overlapping service claims
  • Coding errors
  • Missing information

Claims denial management falls into two basic categories:  

  • Preventing claim denial  
  • Recovering claims through the appeals process  

The top reasons that claims get rejected include coding errors, incomplete information, and late filing.

To manage your claim denials effectively, you need a standard protocol that is always followed. This includes analyzing your current denial data, creating a workflow to handle the appeals process, and appealing within a set period.  

By decreasing claims denials, you shorten the payment cycle, improving cash flow in your organization. To do this, you need to assess the current process and identify areas of weakness. Proactively solve denial risks. Maintain data to continuously benchmark your progress.

A soft denial is usually due to missing information. This type of denial is reversible through the appeals process.

The national claims denial rate is at 11%

Roughly $5 million in claims are denied, per provider, each year

Contact Us

Have any questions? We’d love to hear from you

If you would like to find out more about the service that we provide, please do not hesitate to get in touch with us today on 1 800 552 3301

Alternatively, you can send an email to sales@bizmaticsinc.com and we will get back to you as soon as possible. We are more than happy to arrange a demo for you, enabling you to see how our service works and how denial management can benefit your medical practice.

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All our promotional offers are as individual and unique as the practices and clinics we support.

We look forward to exploring the potential benefits and offers prognoCIS has for you.

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All our promotional offers are as individual and unique as the practices and clinics we support.

We look forward to exploring the potential benefits and offers prognoCIS has for you.

Please fill in your details with the best contact email and phone number.

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