Denials, Appeals & Audit Management

Protect Your Revenue

Denials, Appeals & Audit Management

Identify payer denials and other reimbursement issues in real-time, and automate the appeal process and denial workflow so staff can rework and resubmit claims for faster payment.

Why Clients Choose Us

University Hospitals

“The Denial Management Workflow System identifies denials sooner for worklisting, and provides the key working documents like EOBs right at our fingertips in the process. This is helpful in proactively working our small balance inventory where volume tends to run high. It has also helped head off potential customer service issues by preventing inappropriate patient balance transfers applied to the account as a result of the denial.”

— University Hospitals Elyria Medical Center

Denial Management

Reduce the Complexity in Managing Denials

Quadax provides easy-to-use tools for the automatic creation of custom worklists and intelligent routing of denials to the appropriate staff in your organization for rapid follow-up. Expect to reduce future denials and rejections by improving claim accuracy, and increasing efficiency and staff performance with automation. Features include:

  • Automatic Creation Of Custom Worklists Eliminate manual identification and collection
  • Full & Partial Denials Captured Rescue all opportunities for recovery
  • Flexible Configuration Build routing rules for efficient handling
  • Management Dashboards & Reports Track key performance data
  • Source Documents At Your Fingertips Access key data immediately
  • Appeal Letter Templates Take action swiftly and easily

Denial Workflow

Streamline claim and line level denial workflow, and receive alerts to take the appropriate action for quicker resolution and resubmission of claims.

Intelligent workflow, easy access to source documents, appeal templates, and key denial inventory reporting metrics, permit streamlined denial intervention for rapid revenue recovery.

Appeal Workflow

Manage the entire appeal process and create custom worklists using automation—eliminating manual identification and collection.

Put Quadax systems to work and reduce your staff’s workload through automatic workflow of both partial and full denials, appeal letter scraping, appeal automation for simple cases, and automatic escalation.

Audit Management

Axis provides the processes, workflow and organization you need to even the playing field with the RACs and other audit organizations.

Axis is a secure, hosted application that interfaces with your network to capture documentation required for analysis and appeals. Axis can be stand alone, or integrated into a complete Xpeditor transaction management system. Detailed tracking, configurable workflow, and management reporting streamline your audit response workflow and equip your team to meet audit challenges effectively and efficiently.

RemitMax

Automatically convert EOBs to ANSI 835s

RemitMax by Quadax streamlines your billing office workflow and saves those hard-earned dollars by eliminating paper. Adding RemitMax to your remittance management strategy allows you to get control of all your remittance and correspondence documents—even patient payments—that you or your lockbox now receive on paper. And, the 835s created by RemitMax are subject to the same automation that’s afforded within the Claims Management and Denial Management solutions, such as automated COB claims, denial management workflow and robust data analytics allowing for a more accurate picture of the entire revenue cycle.

Decision Intelligence by Quadax

Data Analytics for Denial Management

Decision Intelligence by Quadax helps you gain better visibility into claim processing, payment and revenue generation data to identify contributing factors and perform real-time root cause analysis. Now you can leverage actionable data for quick resolution to more effectively reach successful business outcomes.

  • Quickly capture denial history to provide actionable analytics to reduce future denials by improving initial clean claim rates.
  • Review contracted claim denials to determine test criteria and if met.
  • Submit multiple levels of provider or member appeals to overturn claim denials.

Claims & Reimbursement Support Services

Rely On The Experts

Quadax revenue cycle experts provide routine, on-site visits to assist with event creation and resolution, continued training, reporting needs, best practices and general issue resolution. Quadax provides the perfect blend of sophisticated technology with reliable, expert, personal support.

We are at your side

Let’s take on the revenue cycle together!

Learn more about the revenue cycle solutions we offer for high-performing healthcare organizations.

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