Denial Management

ADAA’s system helps payers identify underpaid and denied claims, also flags them based on standard parameters followed by symmetrized process:

- Identify

- Manage

- Monitor

- Prevent

Denied claims might be a result from conflicting interpretations of clinical documentations, incomplete or inaccurate information, inconsistencies with third party payer policies, and various other reasons. The denial management team establishes a trend between individual payer codes and common denial reason codes.

This trend tracking helps to reveal billing, registration and medical coding process that are then corrected to reduce future denials, thus ensuring first submission acceptance of claims.