Medical and Health Insurance Advocates

Solutions for Medical and Behavioral Health Providers

Our experts work hard on your behalf so you can focus on helping families and treating patients.

We offer a number of different services for claims and denial management for healthcare providers:

  • Pre-authorization and Utilization Management
  • Peer-to-Peer Reviews
  • Verification of Benefits
  • Insurance Policy Reviews
  • Medical Claim Submission
  • Revenue Cycle Management
  • Insurance Claim Follow-Up
  • Administrative and Expedited Appeals
  • Licensure and provider contracting issues
    • Please contact our office for details on our payment and rate structures

Medical Billing, Claims, and Denials Management Services

Billing and Claims

As your third-party medical billing partner, we strive to remove the insurance burden from your shoulders, so you can focus on treating patients and managing your business. We utilize a dynamic revenue cycle management software and couple that with our decades of experience in medical billing, claims and denial management. Your facility will begin to see a decrease in denials, an increase in authorizations, and more claim denials being overturned on appeal. It is our goal to improve your revenue and claim outcomes, along with minimizing the frustration caused by insurance.

Pre-Authorization and Utilization Management

Denials Management’s pre-authorization and utilization review services are conducted by our team of licensed clinicians who are knowledgeable in policy requirements, medical necessity criteria, and effective communication with Insurance Care Managers. Our clinicians work closely with mental health and substance abuse facility teams to set them up for success during the utilization review process. Facility clinicians are trained by our team on topics such as insurance carrier medical necessity criteria, how criteria differ for multiple levels of care, the complexities of the utilization review processes, and how to create effective clinical documentation.

As a provider, your sole focus should be to restore your patient’s health, not handling disputes with health insurance companies on denied claims. Denials Management, Inc. is the most experienced health insurance advocacy firm in the nation. Our mission is to partner with providers for pre-authorizations, third-party medical billing, claims follow-up and to assist with appeals for any denied insurance claims so that your office and your patients can receive the compensation they deserve.

With over 40 years of experience as medical insurance advocates, our team is experienced in insurance regulation, the laws that govern health insurance policies, and the strategy needed for insurance claim denial management within the healthcare industry. It is our highest priority to operate ethically and never jeopardize a provider’s reputation.

If your patients are experiencing issues with denied health insurance claims, or if your office is struggling to recoup funds for medical bills or obtaining pre-authorizations, contact us today and let us help you fight to recover the insurance benefits owed. We have several different pricing structures to fit your specific needs. Call one of our Provider Relations Experts today to learn more!

 

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