Our Vision

Case Management Covenants (CMC) is a healthcare company that specializes in helping our clients enhance profitability and build value through development of efficient claims and denials management processes. Utilizing our proprietary systems, best practices and an accomplished team of managed care experts, we work with clients to eliminate waste, redundancy and as a result drive significant increases in hospital earnings.

Increasing Earnings & Cash Flow

CMC understands that hospitals and other healthcare providers are undergoing unprecedented earnings pressure. Cash flow is at an all time low. With rising numbers of uninsured patients, reductions in payer reimbursements and increases in denied claims, real earnings are eroding rapidly. To counteract this spiraling financial downturn, many healthcare entities are actively pursuing new and innovative approaches to increasing earnings. Partnering with CMC to enhance your denials process is a quick, guaranteed way to increase earnings.

Minimize Payor Denials with CMC

CMC provides a practical and innovative approach to denials management. We utilize our proprietary “High Touch – High Impact” approach to recover significantly more denied dollars than even the best in-house denial management systems. In addition, we provide reports that are actionable and help our clients reduce denials before they occur. Offering a completely outsourced solution, partnering with CMC enables our clients to free up scarce Medical Management resources and reallocate to processes that prevent denials from occurring in the first place. With no up-front investment and no in-house infrastructure required there is no risk to your organization.

Appeals Tracking Application

Our appeals tracking system ATS is the same proprietary tool we use to effectively manage our hospital clients' appeals. Because the tool has been so instrumental in minimizing denials through the appeals process, we are making it available to hospitals wishing to improve their success at denials mitigation. The tool is both a process tool that streamlines the appeals process and an outcomes tool that measures improvements in the process.

Side Bar Facts/Quotes

"Approximately 5% to 10% of all claims dollars are denied, this represents multi-million dollar write-offs for hospitals annually."

“The very best in-house appeals management programs produce 25% overturn rate, but can cost up to $345,000 in medical resources plus workflow infrastructure investments.”

“Hospitals that focus on core competencies while outsourcing resource intensive back-office operations can improve their overall bottom line profitability.”