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Denial Health Check

Resolve

A Simple Solution to a Complex Problem

Successful denial management is a key piece of both the patient experience and a thriving revenue cycle — with denials increasing in both frequency and volume, the need for effective solutions to assist hospitals in obtaining appropriate reimbursement is critical. Nemadji has developed Resolve, a fully customizable solution to support and optimize your hospital’s existing efforts to ensure you receive the reimbursement you are entitled to.

Hospital staff are stretched thin and deal with many competing priorities—let our well educated and easy to work with team relieve the denial burden on your staff. Our exclusive platform prioritizes denials based on the needs of each facility we work with, to ensure they receive the rightful reimbursement for services provided—with minimum implementation and maintenance.

Denial Health Check
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Good Work! Your denial rate is above average!

Current Denial Rate:
Recoverable Dollars:

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Highlights

Custom Analytics & Recommendations

Nemadji’s custom reports show the current landscape and outlook at your facility—including Cause Reports and Trending Analytics that highlight commonalities across payers that have previously been deemed unrecoverable.
In addition to custom analytics, our team will provide recommendations and suggestions for corrective action based on the trends we see in your data.

Recommendations focus on:

  • How to improve payer contract negotiations for increased claim payment rates
  • Opportunities for increasing revenue/minimizing revenue loss
  • How to fix gaps in coverage

Appeal Templates

Our library of tested and successful appeal templates allow for an expedited appeals process and decrease processing time. On average, our clients see payment 20 days after Nemadji begins their work on an account.

Denial Focus

  • Claim Review
  • COB
  • Credentialing
  • Coding
  • Data Entry Error
  • Duplicate Claim/Service
  • Eligibility
  • Medical Necessity
  • Missing Authorization
  • Timely Filing