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Provider Services 2018-08-13T18:05:42+00:00

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Streamline Your Revenue Cycle Management

Advent’s skilled clinical team delivers a customized blend of services, technology, and clinical/operational best practices. Our specialty is determining the viability of each claim for an appeal – and then overturning those wrongfully denied claims, for which our success rate is 90%.

Plus, our flexible model means you benefit from our resources in the areas where you most benefit, as well as at the times you need it most – whether it’s related to claims backlogs from regulatory changes or a sudden staff shortage.

Advent’s Provider Services: 3 Things to Know

TEAM EXPERTISE

Breadth & Depth

Clinical

Technical

Coding

FLEXIBLE MODEL

Customized to You

Timing – concurrent, pre-bill, first appeal, final appeal

Admissions – inpatient, outpatient

Payers

OUR PROCESS

Focused Plan

Assigned team

Claim viability evaluation

Claim timing prioritization

Advent Client Successes: Claims Overturned on Appeal

  • Provider Care
    • Infant is admitted to the NICU weighing 800 grams and in respiratory distress. Patient received respiratory support and transfusion of packed red blood cells with a two-month length of stay.
  • Payer Claim Denial
    • Submitted claim for a Level III NICU stay was paid at a Level II.
  • Advent Appeal
    • Documented daily patient monitoring, each IV solution, lab results, and oral feedings until the infant began progressing to change levels.
  • Advent Result
    • Successful overturn of appeal.
  • Provider Care
    • Patient presented to the ER with an overdose on prescription medication.
  • Payer Claim Denial
    • Denied as inpatient and paid as an observation.
  • Advent Appeal
    • Based on the specific prescription medication, Poison Control documentation is clear that a 3 day period is required to clear the patient’s body system.
  • Advent Result
    • Successful overturn of appeal.
  • Provider Care
    • Obtained an authorization. Patient was not exhibiting withdrawal symptoms for this DOS.
  • Payer Claim Denial
    • Denied for no authorization.
  • Advent Appeal
    • Determined the authorization was obtained for Revenue Code 128 but submitted claim cited Revenue Code 124 and 126. Verified that Revenue Code 128 was correct based on patient diagnosis. Requested re-bill and submitted.
  • Advent Result
    • Successful overturn of appeal.
  • Provider Care
    • Patient was admitted on 2/8.
  • Payer Claim Denial
    • Payer denied inpatient claim on 2/11 stating patient did not meet LOC criteria.
  • Advent Appeal
    • Submitted with documentation that showed the patient’s condition worsened since the initial denial – and now met inpatient criteria.
  • Advent Result
    • Initially denied again. Advent submitted a complaint to the state with the complete medical record showing this claim met inpatient LOC criteria per MCG guideline for wound complications.

Let’s talk about our clinical expertise and spectrum of services.

LEARN MORE ABOUT OUR SERVICES

Advent On Trend Reporting

What Our Clients Are Saying

“The quality of the denial letters are stellar, citing the most up-to-date evidence-based literature. The feedback that the Advent team provides serves as a clinician education opportunity so that history does not repeat itself… I find their results effective and their costs reasonable considering their expertise in their field.”

Director of Case Management, Regional Health System

“Being able to prevent some of these problems before we ever dropped the bill was really powerful. We were even closer to getting our DNFB to three days or fewer, reducing our rate of denials, and winning by getting the claim paid correctly the first time.”

Operations Executive, Large Hospital

Types of Claims Included in Advent’s Service Offerings

DENIAL PREVENTION

Pre-Bill

  • Concurrent

  • Post-Discharge/Pre-Bill

DENIAL MANAGEMENT

Post-Bill

  • First Appeal/Final Appeal

  • Government Appeal (RAC)

ACROSS

Request an Expert Review of Your Appeal Letters

Advent’s RCM experts will review up to two of your appeal letters, provide redline feedback, and complete a 30-minute follow-up consultation. This customized feedback is designed to improve your letter(s) and overturn more denials.

REQUEST CONSULTATION
855.789.6691