Denials Prevention

The Ciox denial prevention solution will:

  • Provide a unique, holistic, multi-step, multi-discipline approach to denials.
  • Analyze the where and why denials occur and isolate the root cause.
  • Conduct operational review targeting the top areas.
  • Provide ongoing educational support to minimize future denials.
  • Build and maintain a partner relationship with client leaders sharing data.
  • Increase revenue from denial overturns and prevent future avoidable denials through education.

SERVICES

  • Retrospective authorization updates.
  • Retrospective clinical medical necessity reviews and appeals (e.g. Medicare, Medicaid, Managed Care, Commercial, Third Party).
  • Ongoing education to change operational behaviors currently impacting denials.

TEAM

  • Professional team of multispeciality clinicians, active licensures and accreditations in areas of clinical expertise.
  • Thorough understanding of Medical Necessity Criteria throughout the continuum of care as it relates to admission, continued stay, and discharge as well as post-discharge care.
  • Excellent authoring skills and the ability to engage in active clinical discussions as needed.
  • Dedicated to working appeals exclusively.

WORK LOCATION

  • Onsite or remote

Top 5 Best Practices

  1. Effective Use of Data Analytics
  2. Implement Denials Management Technology
  3. Engagement of All Clinical Areas to Prevent Denials
  4. Consistent Prevention Efforts
  5. Partner with Ciox

Interested in learning more? Request a Denials Analysis and learn how Ciox can help raise your denials program to new heights!

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