Denial Management

success button4PRO is the industry-leading expert at coding, denial management and contract management for radiation oncology billing. Of all the revenue cycle solutions we offer, our clients say the denial management process is the most beneficial to their businesses. Our system enforces contracts, flags underpayments immediately for appeal, and promptly stays on top of all correction and resubmission efforts.

PRO’s cutting-edge denial management service:

  • Flags denials for review
  • Identifies and categorizes the reasons for denial
  • Closes systemic loopholes that are causing denials to occur in the first place
  • Provides reports that will guide management to make better day-to-day decisions

PRO provides:

  • On-site staff documentation and compliance training
  • Yearly on-site audits
  • 100% charge capture
  • Extensive training to physicians

Unresolved claim denials and incorrect reimbursement can be financially destructive to any medical practice, so at PRO we make claim resolution and payment accuracy a top priority.  The reasons for most claim denials are commonly related to incomplete or inaccurate insurance information, missing treatment authorization, procedure coding errors, and insufficient documentation of “medical necessity.” PRO helps clients avoid similar denials in the future by tackling them as they arise and sending in appeals that are carefully constructed according to the payers’ specifications.