ReSolve^® Denial Management

Automatic Capture of Denials and Claim Defects

RCMS ReSolve Denial Management identifies and isolates claim denials and defects as they arrive. Working in tandem with ReSolve Payment Processing, it automatically captures denied claims and routes them to the appropriate team members for timely correction and follow-up with third-party payers. Detailed trend reporting identifies the root causes behind each denial, helping revenue cycle teams reduce future occurrences, strengthen cash flow, and minimize process delays.

Identify the Root Cause of Denials

Denial trends can be analyzed and traced to specific areas — from patient access and eligibility to individual physicians, departments and type of service. By identifying the source of each denied claim, Denial Management allows staff to resolve the root cause of denials, reducing the initial denial rate of future claims and providing a true process improvement solution.

RCMS ReSolve Denial Management automatically captures denials and routes them to appropriate work queues for timely follow-up. By identifying and tracking the root cause of denials, true process improvements are realized.

Track Denials from Follow-Up to Payment

ReSolve Denial Management reduces cost-to-collect through powerful workflow and reporting tools. KPI tracking, dynamic drill-down reporting, and charting provide real-time visibility into claim status, denial trends, productivity, and more. The application tracks the complete denial management cycle, helping teams identify which follow-up efforts result in payment and where additional action may be needed. Documenting the lag time between follow-up and collection also provides valuable insight for payer contract negotiations.