Medical Claims and Denial Management - Services >> Denial management

	Denial Management
	Accounts Receivable
	Zero Balance Audit
	Consulting

	· Denial Management
	Accounts Receivable
	Zero Balance Audit
	Consulting

Services | Denial Management

Inappropriately denied claims contribute to every hospital’s reimbursement dilemmas and account for
a significant portion of lost revenue. MCDM thoroughly reviews and vigorously pursues recovery of
wrongfully denied hospital claims, including inpatient, outpatient and emergency room claims, offering clients the customized services that can impact their bottom line. Although MCDM does not provide legal advice or representation, we have specialized business experience to perform the following:

• Evaluate claims for validity
• Analyze claims for clinical or administrative denial
• Secure necessary documents to appeal claims
• Resubmit claims to payors, together with customized appeal letter, as appropriate
• Monitor the administrative appeals process from initial petition through second- and third-level appeals
• Negotiate claims resolutions
• Prepare and issue periodic claims status reports
• Assist the client’s legal counsel in the litigation process