We track every claim that is denied and present it in a manner that allows fast identification of
trends. With this kind of powerful intelligence in hand, we can dramatically drive up the first time claim acceptance rate and stop the torrent of claim denials.

Some of the key functions of our denial management process are as follows:

• Identifying the root cause of denials – We identify and interpret patterns to quantify the causes of each denials.
• Supporting accurate workflow priorities – We collect every piece of information related to denied claims, including status, escalation and correspondence with payers, which will be very helpful in streamlining the recovery process.
• Providing timely and accurate statistics – We provide accurate analytics and reports that can go a long way in preventing future denials.
• Rejected Medical Claims for Appeals
  • Appeal plays an important role in the RCM cycle when a claim gets denied or underpaid. Before fling an appeal, it is important to evaluate the claim to determine whether it is worth spending the time and money. At Yosa our well trained RCM specialists review every intricate denial and understand the possibilities of an appeal to ensure they are cost effectively resolved and most importantly ensuring that we give priority and act within the specific appeal time frames of each insurance so that our efforts are not exhausted and would result in revenue that would benefit both the provider and the biller.

AR FOLLOW UP

Here our team of accounts receivable management experts rigorously tracks all unpaid  insurance claims that pass the 30 days’ bucket and ensure that they are collected, thereby greatly reducing accounts receivable (AR) days. They also ensure that all underpaid claims are processed and paid correctly by the insurance payer, while making sure that all the denied claims are appealed in time.