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Appeals and Denials Utilization Review

Recover Lost Revenue and Decrease Future Denials

Though your staff and providers are well-trained, it is inevitable that your facility will receive reimbursement denials. While some are valid, others provide opportunities to follow up with providers to ultimately recover lost revenue. This important—but time-consuming—exercise of reviewing records, care, and provider contracts may not fit onto your staff’s already-full plates. Soyring Consulting, a Press Ganey Solution, can help.

Based on a high-level analysis, the Soyring team can work remotely through your facility’s unpaid claims by compiling and composing the following information:

  • Payers and their contractual requirements
  • Medical record and relevant databases
  • Inpatient versus outpatient designation
  • Pre-authorization status
  • Appropriateness of care provided

We will appeal the unpaid claims or recommend for re-bill or coding changes for all denied claims, including private payers, Medicare, and Medicare Advantage.

In addition, we can develop a systematic process to prevent or minimize future denials based on current denial causes and establish the process steps and tools for timely identification, notification, and communication of denial(s) status.

“Soyring has proven project management techniques, and most importantly you have a great success record.”


Explore a Consulting Engagement to Tackle Your Facility's Appeals and Denials.

Contact us today at 1.866.345.3887 or simply fill out this form & we will contact you.