Q: I don’t have the time to data enter claim information into another system. It seems like I would just be stepping over dollars to pick up pennies. How can this product benefit me?
A: ClaimSaver Pro has automated interface capabilities. Not only can your denied claims be automatically loaded from your patient accounting system into ClaimSaver Pro but pertinent data that is entered manually into ClaimSaver Pro can be loaded back into the your host database by a simple click of a button. Furthermore, during the initial system implementation, your denial codes, carrier information and service codes can be automatically interfaced into ClaimSaver Pro.
Q: Our IT Department is so overworked already, how can interfacing this product possibly save time and money if IT has to build an interface?
A: There is little to no IT involvement required on the facility, physician office or clinic side. We at DMI build the interface for each of our clients and maintain the system from our corporate location.
Q: Our business office has the most efficient revenue cycle processes and software available. We don’t have a claims denial problem. Why would we want to spend the money for something we already have our arms around?
A: “ If you think your hospital doesn’t have a problem with denials, then you aren’t doing anything to track them” Christine Collins, CHAM, director of patient access, Brigham & Women’s Hospital, Boston, MA
Q: If we were to purchase your product, how long would it be before we can expect to realize a return on investment (ROI)?
A: Larger facilities (300+ Beds), on average, realize ROI in as little as 90 days. Smaller facilities, physician offices and clinics are more likely to realize ROI in 180-240 days.
Q: How much time and resources are we going to have invest in the implementation of this product?
A: Implementation generally takes less than one weeks time and requires little IT involvement and business office staff time. Training is the most invasive part of the process, yet it only takes 1-2 days.
Q: What kind of a learning curve will take place during implementation of the product? Is there training provided?
A: Training is provided during implementation and generally takes 1-2 days. ClaimSaver Pro is extremely intuitive and user-friendly, so there is little to no learning curve. Sustaining the product is done mostly by DMI. There are aspects of the system that DMI can train on for IT involvement, i.e. custom report building and other customization, however the training on these aspects only takes 1-2 days on average.
Q: What kind of support services are you committed to once we implement the product?
A: DMI provides full technical support for ClaimSaver Pro and other related products, as well as technical phone support for any complications that may arise. Our office can be contacted during regular business hours for Free support (Mon-Fri. 8am-5pm MST).
Q: What other services do you provide besides Denials Management, Inc. software solutions?
A: In addition to our comprehensive denials management software, ClaimSaver Pro, DMI provides expert refund request software, Refund Pro, credit balance software, Credit Balance Pro, and claim services. Our claim services include: EOB Audits; Denials Management; Contract Review and much more. Please click here to see the “Services” page on this website.
Q: How much experience does your company really have in claims denials management?
A: DMI has been working in denials management for over 15 years and has worked with every type of claim denial, for every type of healthcare provider.
Q: Have you had success on appeals that have had to go to litigation?
A: ClaimSaver Pro’s automated Insurance Grouping and reporting features have been key assets for multiple successful litigations with even the largest insurance carriers.
Q: Do you have to be a large facility to realize an ROI or can a single user medical practice see a financial benefit from the use of this product?
A: Small clinics, medical practices and even single physician office realize an ROI within a few short months. Also, what they don’t see know – they will see later as they are able to look at trends for each of their payers and utilize the consolidated information available through our delivered report features to collectively appeal multiple claims, regardless of the dollar amount, and negotiate acceptable litigate rates with attorneys due to the leg work that is done automatically by simply using our software.
Q: I like what I see and I’m interested in marketing your product. Is there a reseller program and how can I get involved?
A: Yes, there is a reseller program. Please click here to see the “Reseller Program” page of this web site.
Q: What do the experts have to say about managing health insurance denials?
“A denials database should be in place to help track the type of problems that occur”
Julie A. Micheletti, Director Clinical Product Strategies, HSS, Inc.
“The benefits of denial management include accelerated cash flow, reduced write-offs and improved management information”
Lori Laubach, CPA
“People should assume that they’re entitled to care and equipment until the insuring agency proves that they’re not”
Joseph Romano, Author Legal Rights of the Catastrophically Ill and Injured
“Providers are penalized financially by payers for not being able to submit their claims on time” “I think CEO’s need to realize that they have a 3% opportunity here to improve their revenues. They need to acknowledge that there is an opportunity – not a problem - to improve revenues by working their denials”
David Harris, Partner, PricewaterhouseCoopers, New York, NY
“What we do that’s wonderful is assign denials so we can track them. If a denial comes to my office, but is clinical, I reassign to a person who can handle it” ”Most hospitals, don’t have the IT to have this information at their fingertips – who’s working what?”
Christine Collins, CHAM, dir. of patient access, Brigham & Women’s Hospital, Boston, MA
“A 2003 study by the Health Insurance Association of America found that 14 percent of all claims received by payers were denied”
Pam Waymack, CHFP, Managing Director, Phoenix Services Managed Care Consulting, Ltd.
“Persistence in appealing denials is often the key to a successful claims recovery strategy”
HFMA: Tip Sheet – 06/28/2005 - materials derived from HFMA’s February 6, 2002 Audio Webcast.
Most health systems lose between 3% to 5% of net revenues as a result of payment denials from insurance companies.
Five Keys to setting up a denial-management program:
- Focus on the problem as an organization-wide opportunity to recover revenue.
- Invest in systems to track and report denials.
- Deveop standards for reporting types of denials and communicate this information throughout the organization.
- Assign responsibility for denials and reward people for improvements in denial rates.
- Measure results on an ongoing basis.
Information obtained from an article posted in healtcare.pwc.com entitled “Are you in Denial Over Your Denials?” by Modern Healthcare, PricewaterhouseCoopers and Denials Management, Inc. – Providing the most comprehensive and robust denials management software solutions in the industry.
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