Denial Management
Clinical denial backlogs happen, but we’re here to help. Advent Health Partners’ flexible model allows us to supplement your denial management team when, where, and as you need it.
Clinical denial backlogs happen, but we’re here to help. Advent Health Partners’ flexible model allows us to supplement your denial management team when, where, and as you need it.
A 90+% Overturn Success Rate
Choosing the right denial management partner can help your organization reduce time to revenue and decrease the cost to collect. With best-in-class technology and deep clinical experience, Advent Health Partners can not only help manage your organization’s current denials but serve as a partner to strategically prevent your denials, as well.
Why Use Advent for Your Denial Management?
Clinical Expertise
Our dedicated team of RNs have experience in several specialized fields including cardiology, NICU, PICU, oncology, and wound care. This ensures that we can provide a comprehensive level of service to your organization based on your individual needs.
Industry-Leading Technology
Root cause reporting and analysis are at the core of denial prevention, and at Advent, that begins with our Optics platform. Optics brings together all of your 835 & 837 claim and denial data to be viewed in easily understood dashboards.
Flexible Partnership
Advent flexes to your needs regarding services, admission types, and volume of cases.
Comprehensive Defense
In the unlikely event of a denial, Advent defends our work throughout the life of the claim—at no additional cost.
Validating Medical Necessity
In 2022 Advent Health Partners recovered $1.3MM on average for our hospital and health system partners of all sizes: small, medium, and large. Increase overturned denials and recover more of your organization’s revenue by leveraging our expertise in validating medical necessity.
Combat Prior Authorization Denials
Prior authorization is one of the top causes of claim denials for hospitals and health systems, leading to millions of dollars in lost revenue every year. Advent Health Partners has the clinical expertise and the technology to help your organization combat prior authorization denials.
Sample Appeals
Our appeal letter structure is at the core of our 90+% appeal recovery rate. Writing an appeal is an art form, and crafting an organized and compelling appeal letter is key. Check out an example of a medical necessity appeal letter below to see our structure and best practices.
What Makes Advent Different?
Monthly Status Report
Details your claim inventory status, providing a claim roll-up of the activity taken on the claims, where they currently reside in the process, and final claim resolution.
Executive Summary
Overviews metrics for designated period and may show trends not easily seen within the project. Helps escalate any issues or opportunities for both Advent and client.
On-Trend Report
Case-by-case review to determine appeal opportunities. Aggregates and outlines the story of your denials plus our recommendations for addressing root causes.
Standard Graph
Illustratively depicts claims appealed and recovery results. Specific graphs can include appealed amounts by payer and/or denial type plus closures by reasons and/or payers.
Improving Denial Rates with Appeal Management & Pre-Bill Reviews
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