The DenialManager Software, developed by BillingParadise, is a robust, data-driven solution for healthcare organizations (hospitals, group practices, and clinics) to automate, simplify, and demystify the denial management workflow. The software is a proprietary tool that is often provided free of charge to clients utilizing BillingParadise's Revenue Cycle Management (RCM) services. It uses comparative and predictive data analysis to identify, isolate, quantify, and categorize denials, helping to lower the denial rate and spot revenue leakage sources.
Key Features and Capabilities:
- DenialAnalyzer: Groups denial codes into different classifications to help users identify and eliminate root cause issues.
- Integration: Automatically extracts denial information from existing EHRs, practice management systems, and billing software, including major systems like Epic and Kareo.
- Access & Reporting: Offers mobile and web access for real-time monitoring and provides one-click comparison reports against a comprehensive database of industry standards (like MGMA MAP keys).
- Workflow: Provides role-based access, structures the denial management process, and includes alerts and reminders for denial teams. It is customizable, allowing users to create edits, customize templates, and add notes.
- AI & Analytics: Leverages AI for advanced analytics, detecting and automatically routing denials, and speeding up the resubmission process.
Target Users and Benefits:
- CFOs: Gain in-depth analytics, monitor payment variances, spot outliers, and create financial forecasts.
- Practice Managers: Increase staff productivity, tighten RCM processes, and improve bottom-line benefits.
- Denial Teams: Structure the denial management process with easy and effective communication.
BillingParadise reports that the use of their denial management system has resulted in a 72% decrease in denial rate, 72% productivity improvement, and a 36% reduction in aged A/R for clients.
