APPEALS PROCESSING

 STRATEGIZING FOR A HIGHER SUCCESS RATE

Appeals are an important part of the medical billing process. Appealing on a denied claim with sensitivity to its specific timeline is critical for the healthcare provider to recoup money. Moreover, if you are able to identify a pattern in claims that are denied, and the existing practice isn’t helping much when it comes to appealing on those claims, it means the physician or the healthcare provider is not aware of compliance issues or guidelines and the current billing process is incorrect by default.  It also goes to show that the healthcare provider or the physician isn’t doing much to rectify these errors.

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Appeals-process

At QWay
we improve your Appeals process by:

  • Using a strategy for Appeals: Most of the time it is so, that the healthcare provider is unable to appeal on every denied claim. Focusing on the high $ value claims and leaving out claims of smaller denominations which may have a potential chance of reimbursement after appeal. At QWay Health we devise an appeals strategy which is sure to deliver results. It is also a proven way to have you appealing on all the right claims in order to make the efforts worth the returns.
  • Categorizing and Tracking Denials: We categorize denial by type/person.  This methodology helps us identify patterns in denials and enables us streamline the process.
  • A strong Appeal letter: Using a standard template to draft an appeal letter may not be a wise thing to do. We customize every appeal letter based on the type of denial. While we take all the necessary precaution to include important details we quote industry guidelines, CMS and CPT guidelines and the payer’s reimbursement guidelines to give the appeal a higher likelihood for clearance.

Appeals Processing at QWay is done just the right way, in the right time and with the right documents and only for the claims deemed fit.

COMPLIANCE / AFFILIATIONS

We Respect Rules & Regulations

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HIPAA

Compliance to HIPAA regulation

HBMA
HEALTHCARE BILLING

Robust quality system with stringent controls at highest standards of data security.

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ISO 9001:2015

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