Physician Education and Intervention
Physician driven denials are the leading cause of lost Hospital revenue, and are usually systemic of other weaknesses in the Medical Management process. Let our Doctors work with your doctors to identify the drivers of these denials and develop processes, including care pathways to minimize physician driven denials.
Is reducing Denials a current goal of your facility? Do you feel more can be done?
Please see “How do I effectively evaluate my current appeals process?”
There is always room for improvement. CMC is the industry leader in the appeals management process, and can provide budget neutral solutions, with zero up front cost, seamless integration and no draw on facility resources that ensure our clients the greatest ROI for their money, the highest recovery rates of lost revenue, and a year over year reduction in denials as a whole.
Medical Management Audits
You have spent considerable time, money, and resources in an effort to increase the overall quality of care create efficiency and reduce costs. CMC can quickly help you evaluate your medical management processes to identify current and potential future vulnerabilities of lost patient revenue, and provide recommendations that are cost effective ensuring the greatest ROI, while not sacrificing quality patient experience.
Medical Management Consulting and Process improvement
CMC can work with you to strengthen your current medical management processes, including concurrent review, appeals and physician advisor services and work with your executive team to identify key areas of opportunity and develop enhanced processes to minimize denials and increased profitability.
Our clients say that our reporting capabilities are one of our greatest assets.
CMC utilizes patented, proprietary analysis tools to provide you with interpretive and actionable reporting that can drill down to the Staff, department, procedure, Physician, and process level to identify current and potential vulnerabilities in your facility. We then go further to provide actionable cost effective proactive solutions that will minimize liability and lost revenue while maintaining or increasing quality of care, efficiency and patient experience.
Real time tracking of work flow processes, and data collection technology is a MUST for any proactive denials management
Drawing on our decades of Denials Management experience, and in the absence of any reliable technology, Case Management Covenants has developed the most powerful tool for combating recovering and eliminating physician driven denials. The tool generates root cause denials data to help you clearly identify the root cause of your denials and address them efficiently. The tool also tracks every facet of the appeals process and provides detailed process and outcomes data on the appeals process. This type of tool is a must for any successful appeal process.