Denial & Appeal Management Solution
Appeal and Recover Revenue for Claim Denials
The time-consuming process of denial management—which includes tracking claim adjudication, identifying denied claims, researching reasons for denials, collecting necessary documentation, and writing and submitting appeals – need not be so laborious. ZirMed’s Denial and Appeal Management solution reduces the time spent researching the denial and appealing each claim by as much as 33 minutes versus doing it manually.
To streamline your workflow, ZirMed automatically surfaces and routes workable denials for resolution based on your assigned workgroups while removing adjustments you don’t want staff to work. ZirMed gives your staff the ability to check eligibility with one click, rework, and resubmit any claims denied. ZirMed’s Denial and Appeal Management solution also auto-populates payer-specific letters and attaches all necessary paperwork for payer appeals. Personalized performance dashboards by workgroup and individual staff member keep everyone focused on results.
Expedite Revenue Recovery
Accelerate your reimbursement with 100% paperless appeal packages. ZirMed’s denial and appeal management solution provides the ability to auto-populate more than 900 payer- specific appeal letters. ZirMed helps you automate the batching of appeals and attachments to payers. ZirMed even ships and mails appeals and any associated attachments on your behalf.
Improve Financial Viability and Management
Managers can easily review performance and trends, drill down into the data to analyze root cause by reason, score and evaluate payer performance, and view clear reporting on staff performance and the financial impact of claim denials. ZirMed ‘s Denial and Appeal Management solution integrates with practice management and health information systems. Documentation of all activity and notes are delivered back to your system daily.
By design, ZirMed’s revenue cycle management platform enables creators of healthcare technology solutions to seamlessly and easily incorporate our HIPAA and PCI-compliant applications and transactions into your software solutions. Using ZirMed’s integration capabilities, organizations seeking a traditional approach of exchanging EDI transactions may transmit and receive a variety of claims, payments, eligibility inquiries, and other healthcare transactions using established technologies and methods such as X12 files, APIs, Flat Files, FTP, Encryption (i.e. PGP), and more. You’ll have confidence knowing that your exchanges are occurring securely, in compliance with all regulatory guidelines, and utilizing existing technological capabilities.
“We can quickly create a file and appeal electronically. ZirMed has significantly improved our response times, which is having a big impact on our DSO and cash collections.”
– Donald Hoskins, Revenue Cycle Manager, Consolidated Health Systems