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Denial Management

» Fact

• Hospital Outpatient Prospective Payment System claims error rates = (8%-30%)
  • Coding errors = 56%
  • HCPCS errors = 86%
  • CDM-originated = 79%
• 25% - 40% of all claims are either delayed via editing or are denied
• 50% of denied claims are never re-filed
• 90% of denials are preventable
• 67% of denied claims are recoverable

With effective denial management solution, the majority of these denials can be prevented and revenue recovered. Healthcare managers need quick, realtime access to their outpatient book of business. Trans-Quest' denial management and database reimbursement tool, translates your data into the information you desparately need to effectively track and manage claims denials, identify denials by revenue codes and CPT/HCPCS codes, make informed decisions based on a comprehensive denial management report and to survive under APCs. PostLink provides a data quality solution to assist you on multiple fronts, including: reimbursement and denials management, healthcare compliance, JCAHO standards, and performance improvement.