AR & Denial Management


AR Management

Accounts Receivable (A/R) Management

The long receivables cycle increases revenue delay, destabilizes cash flow, fatigues billing staff, and frustrates financial management for healthcare providers.

Some factors further complicate this problem, including inaccurate and correct claims denials. This process can be significantly improved using our Accounts Receivable (A/R) and Denial Management services. Assuring accurate reimbursement of claims is our team's primary goal.

Account Receivable Management consists of many processes. They aim to find denied or unpaid claims, make sure they are re-filed, reduce A/R days, and cut aging claims.

Health Care Providers can easily keep track of their credit history and accounts with WiseMed Solutions. Accounts Receivables are managed through extensive follow-ups. By using follow-up by phone and email, we make sure that patients are aware of their debts and resolve any payment issues as soon as possible. This enhances the healthcare organization's financial performance since it ensures the Medical Billing department receives payments on time.

The importance of A/R Follow-up
It is expected that hospitals, physicians, and nursing homes will continue to offer a broader range of medical services. In this case, Accounts Receivable (A/R) follow-ups play a critical role in the success of the process. As a result, health service providers can run their businesses efficiently and effectively while ensuring the money owed is paid back quickly.

How WiseMed Solutions Can Help?

The following are the services we offer in A/R and Denial Management:

● Resolving claims at once: Our goal is to resolve claims immediately instead of waiting for their status.
● Workflow automation to reduce effort: Using web portals lessens the effort of manually checking claim status.
● Reports and metrics: We generate multivariate reports to aid us in resolving A/R.
● Reducing A/R days and increasing collections: Reducing A/R days by 20% and increasing collections by 5% to 7%.


Denial Management

Human error accounts for most denials. As part of our appeal process, we track down your denials and analyze and resolve them efficiently. Data errors or missing information is the most common cause of denials. Each code is classified based on its type and the person accountable for it.

For a successful denial resolution, we follow a roadmap, considering the criteria necessary for getting correct, actionable data - this helps us report rejections on time and spot account changes.


Importance of Denial Management

  • Faster approval of insurance claims.
  • To prevent future recurrence of denials by integrating software and automating workflows.
  • When rejected or unpaid claims are processed correctly, the approval rate improves and saves time. The Denial Management team works closely with insurance companies to file claims and give correct information, thereby improving revenue cycle management.
  • Achieve quality care with less paperwork and more time for quality care.