AdvancedMD Denial Mgmt is not a standalone product but a critical feature set and service offering within the AdvancedMD all-in-one cloud-based platform for Practice Management (PM), Electronic Health Records (EHR), and Revenue Cycle Management (RCM). The denial management capabilities are designed to help medical practices, especially small to mid-sized and large multi-specialty clinics, optimize reimbursements and improve financial visibility.
Key capabilities are centered around maximizing the first-pass claim acceptance rate (reported at 95%) and efficiently managing the remaining denied claims. This is achieved through:
- Automated eRemittance Posting: The system automates the process of posting Electronic Remittance Advice (ERA) to significantly reduce manual workflow, systematically matching office visits with charges, and creating customizable rules around payment types.
- Denial Management Worklists: The software builds actionable worklists for denied and unexpected payment amounts, allowing staff to focus their time on denial resolution and appeals.
- Claim Scrubbing: As part of the RCM service, AdvancedMD scrubs all claims for errors before submission to payers, which is the primary driver of the high first-pass acceptance rate.
- Expert Follow-up: For practices utilizing the full RCM service (priced as a percentage of collections), AdvancedMD's billing experts handle the entire process of turning denials into approvals and following up on outstanding balances from both payers and patients.
This feature is unified with the EHR and patient engagement tools, enabling a complete, integrated workflow from patient scheduling to final payment posting.
