Conifer Denials & Appeals Management
Conifer Denials & Appeals Management gives your organization the power to recoup revenues lost through inappropriate clinical, technical and administrative denials-without shifting staff resources away from patient care. Our experienced nurses use their knowledge and skill to resolve all types of denials, even the most complex requiring extensive review of the medical record. We’ll help reduce your denial backlog and apply best practices that could reduce denial rates over the long term. We bring you the benefit of years of knowledge gained from working with other hospitals and apply these best practices immediately-from appeal strategies to writing effective appeal letters. As we work your accounts, we’ll identify the root cause of denials and work with your teams to implement effective strategies and process improvements to reduce costly delays in payment.
- Keep clinical resources focused on patient care
- Reduce your administrative and clinical denial backlog
- Apply best practices that will reduce denial rates over the long term
- Support your compliance activities
- Mitigate the effect of regulatory changes on your reimbursement
Clinical Denial Review and Appeal
Appeal and pursue all types of clinical denials with commercial payers, with support from our team of licensed nurses.
Clinical Underpayment Review and Appeal
Recapture underpayments resulting from conflicting interpretations of clinical documentation, payer policy and other reasons.
Government Audit Review and Appeal
Review and appeal adverse findings received from government payer audit contractors and programs.
Macro-Level Interaction with Payers
Work with every major commercial and government payer, understanding the complexities of their systems and processes, to help prevent denials and streamline operations.
Reporting and Analysis
Provide monthly, quarterly and annual reports about denial volume, trending, processing and resolution to guide process improvements and support future payer negotiations.