Denials Management

Adreima provides hospital clients with the resources necessary to evaluate denied claims and when appropriate, pursue additional payments for these claims. By leveraging our clinical staff and our receivables management expertise, we are able to provide an end-to-end solution for the problem of denials management. This eliminates the need for hospitals to set up overlapping systems and processes, and helps to maximize revenue collections.

A primary focus of our Denials Management team is to identify opportunities for process improvement and change that will result in fewer denials of future claims by identifying recurring issues and assisting the hospital in correcting them. Reports from our proprietary systems provide detailed analysis of reasons for denials, success rates, and information to direct corrective actions. This allows the hospital to zero in on the denials that result in the highest recovery, and address issues of process and procedure.

As a team, we identify the clinical, legal and technical denials that represent a challenge for your hospital. Our Registered Nurses and Patient Account Specialists work these claims to resolve and recover additional revenue for the hospital. These services are augmented by our long-standing relationship with Gammage & Burnham, a premier Phoenix based law firm known for its specialized practice in health care reimbursement.

Benefits Include:

• Allows hospital staff to focus on concurrent issues by outsourcing retroactive concerns
• Identifies and corrects systemic issues, enabling the hospital to bill future claims correctly
• Leverages clinical staff to resolve denials without additional hospital resources