Solutions

Denials, Appeals & Audit Management

 Defend Your Revenue

Maintaining a strategy to manage your remittance denials and respond to payer audits is critical to the health of your revenue. According to the Medical Group Management Association (MGMA), 65% of claim denials are never appealed. This is likely because appeals audits can add complexity and cost. The American Hospital Association’s (AHA) recent RACTrac survey indicated that over 70% of hospitals reported a spending average of over $80,000 annually on Medicare RAC audits alone. This represents a significant area of opportunity—take action and defend the reimbursement you deserve. Integrated solutions for Denials, Appeals, and Audit Management from Quadax let you execute targeted appeals to recoup more revenue with less time and effort than you thought possible!

Go Beyond Recovery to Prevention

Develop campaigns with our Denial Management solutions to categorize claim denials, analyze root cause, attain process improvement, and track progress. You will also have the ability to review claims in pre-billing that have been identified as those targeted by Medicare for audit. With Quadax, a proactive approach to Denials, Appeals & Audit Management results in fewer future denials.

 

Catch Full and Partial Denials

Line item and complete claim denials are immediately added to electronic worklists and captured for reporting based on your business rules.

 

Gain Valuable Insight

 

Trend reporting yields actionable insights for process improvement and measures the impact of those efforts.

 

Maintain Full Accountability

 

Closure reasons, complete audit trails, and detailed reporting keep your fingers on the pulse of your recovery process.

Generate Appeals Quickly and Easily

Pre-loaded, customizable appeal letter templates save valuable time and effort.

Never Miss a Deadline

 

Easily assign workflow tasks based on business rules, and customize deadlines and notifications.

Skip Hunting and Gathering

 

When you receive a Medicare RAC audit, or other payer audit letter, easily retrieve the affected claims and seamlessly add them to your audit workflow.

 

 

PREMIUM TECHNOLOGY + DEPENDABLE EXPERTS = EXCEPTIONAL RESULTS

You expect first-rate technology, and Quadax delivers. Our systems are engineered for efficiency, intuitive use, and flexibility. Because we developed our software, we created purpose-built, fully-integrated functions and features that deliver results—simply put, Quadax solutions are designed to give you full control in the midst of a complex reimbursement environment.

The experts of Quadax are people you can depend on for person-to-person support. We engage our clients as partners in the process of continual improvement of their performance and of ours; because of this, Quadax enjoys client relationships that have endured for 10, 15, 20 years or longer.

Quadax clients see results: meeting of exceeding cash goals, increasing efficiency, eliminating waste and redundancy, and reducing the cost to collect.

“Using Denial Management by Quadax, we’ve been able to better define and understand our internal coding issues, which we were never able to do before.”

Lynda Walters, Medical Center Barbour, Eufaula Alabama

Lynda Walters Medical Center Barbour, Eufaula Alabama
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