HomeTown Health Information Prevent and Work Denials with Technology! Provided By: Kerry Elledge, Quadax

DM X Generic 835 Screenshot ANSI 835: Loops, Segments and Data…Oh My! Convert to “Human Readable” EOBs

DM X Without technology, data consolidation is difficult and excessively manual Technology allows for consistent reporting, data mining, data sharing and root cause analysis. There is too much data to handle manually and there are limited resources already at hospitals. Minimizing/preventing denials is one of the greatest opportunities a hospital has to improve cash flow and reduce write-offs. PREVENT, PREVENT, PREVENT

DM X Administrative Denials: Report and Trend Review Denials by Payer to Identify Trends – Payers Interpret ANSI Reason Codes Differently

DM X Administrative Denials Drill Into Administrative Type Denials to Determine Root Cause and Implement Preventative Measures

DM X Administrative Denials

DM X Without technology…paper, time and work effort are wasted in manual processes Technology allows for denial capture, denial workflow, denial inventory management, and in some cases easy access to key documents a follow-up staff member would need. Denials will not go away and resubmission/appeals need to be done timely (or they may result in write-offs) RECOVER, RECOVER, RECOVER

DM X Automate Denial Workflow Full/Line ID & Queuing Flexible Worklist Set-up Easy Access to Key Documents Inventory Reporting & Dashboard Tracking Comment Upload IDQueueReviewResolveCollect..

DM X System Benefits – Quadax Automatic Delineation of Full and Partial Denials No more reliance on manual remit copies to identify line item denials Immediate Assignment of Error Category Groupings Use (denial) error category groupings for efficient workflow set- ups Immediate Denial Notification When 835 Received Eliminate Reliance on Posting Process Eliminate Manual Poring Through ATB to Identify Denials Reduce black holes and inadvertent write- offs Increase staffing efficiencies and encourage process improvement Huge paper and time saver – decrease days in A/R

DM X Automated Access to Key Info All data available with a click of a button: EOB’s, Appeal Letters, Claim…..

DM X Management Inventory Insight No more manual compilation of management reports – many available..

DM X How Can Denial Automation Benefit Your Organization?  Decrease Overall A/R:  Quickly identify both full and partial denials and route them to users with best skill sets to work them  Provide easy access to key denial source documents for follow-up users  Decrease Costs to Work Denials  Improve staff efficiency in working denials by setting up default orders within worklists to group similar types denials  Increase Visibility of Denial Aging Inventory  Utilize management dashboard reporting to target key denial inventory issues