Denials Management, Inc. was established in 2002 as a denials management software company. DMI is a sister to Claims Management, Inc. Claims Management, Inc. has been providing denial services to healthcare providers and families since 1990. The strength of our success comes from our vast claim knowledge along with our tried and proven claim methods and claim handling procedures. In collaboration with CMI, Denials Management, Inc. creates unique claim resolution software and process solutions. We have compiled years of denial processing experience into software and web packages that take our clients through a step by step course of action for every denial reason they may encounter.
Claim handling procedures are ever changing. Healthcare providers and families need to have expert advice and resources at their fingertips to navigate all of the complicated administrative appeal processes.
Denials Management, Inc. is the nation's premier Healthcare Advocacy Firm, delivering families and health care providers high quality insurance billing, claims, and appeal services in the medical and mental health spheres. While maintaining a superior level of healthcare and insurance industry expertise, our knowledgeable staff strategically and tenaciously advocates for benefits and reimbursement owed to our clients. We strive to hold insurance companies accountable to state and federal laws by demanding compliance. It is our mission to influence the way insurance companies do business, one appeal at a time.
-Estimates vary, but studies have found that up to 95% of denied claims are not
appealed. Most people fail to appeal because of the difficulty of wading
through the process.
A 2006 study by the industry group America's Health Insurance Plans found
external reviewers decide in favor of the consumer about 40% of the time.
-The National Alliance on Mental Illness found that patients seeking mental health
services from private insurers were denied coverage at a rate double that of those
seeking medical services.
-Patients with mental illnesses are often forced to make a certain number of outpatient visits
before gaining approval to enter a residential facility. That so-called “fail first” process is nearly
unheard of on the medical and surgical side.
In March 2011, a study by the US Government Accountability Office found that 11 to 21 percent of all claims submitted to insurance companies across the United States are denied. With a rise in erroneous claim filing, and the number of medical bankruptcies and slow paying claims steadily increasing, we truly believe families cannot afford to let denied claims go un-rectified.
The American Medical Association published the fourth annual National Health Insurer Report Card in June of the same year, and found increasing inaccuracy in Claims Payment. Nearly $1.5 billion a year is spent in avoidable administration costs for incorrectly processed claims. Mistakes are not patients' or the family's fault. FixMyClaim.com can help.
Figures collected by the Physicians for New Healthcare Policies of California discovered medical bankruptcies accounted for more than 62 percent of all bankruptcies in the United States in 2010.
Denials Management, Inc. and it's affiliates have been successfully appealing denied insurance claims for over 22 years. In our years of reviewing and appealing denied claims, it has consistently been our experience that 70 percent of these denials are reversible in whole or in part.