Denial Management & Appeals Services

Enhance Your Medicare, Medicaid or Commercial Healthcare Revenue Cycle

The sphere of healthcare reimbursement is an intricate one, which should be discussed with a strategy on mind. NexCure LLC understands the hardships that healthcare providers undergo regarding the processes of claim denials management as well as the provision of the most favorable reimbursement prices. To this end, we have thus devised viable denial management and appeals services that will enable you to smooth your operations, minimize losses and to ensure that you record a sustainable expansion in your revenue.

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    NexCure LLC is the choice to fill your Denial Management

    The denial of claims to the medical professionals in the United States is equivalent to an uphill battle since nearly 10-15 percent of the medical claims are first turned away initially. Of them only half will be successfully appealed. It is as a result of these figures that it is important to implement proactive denial management strategies. NexCure LLC rises to address these issues by offering the solutions of extensive denial management and appeals services that are respectful to a unique nature of healthcare practices.

    Our Data-based Whole-Life Strategy

    We believe in an all-inclusive evidence-based denial management at NexCure LLC. We are not only providing case-by-case services to surmount individual denials, but also examine how to eliminate systemic issues that increase denials. This approach in combination with each other will ensure a long-lasting performance of your reimbursement outcomes.

    Real-Time Denial Identification Categorisation

    Our sophisticated, in-office system operates within your Electronic Health Records (EHR), Practice Management (PM) systems and in the clearinghouses to detect denials on a real-time basis. All the denials are well categorized based on their cause, payer and the nature of denial. It is this type of classification that enables us to prioritize in solving our problems in such a manner that our crucial denials can be addressed on priority basis

    Explanations on High Denials of Claims

    The background of the denials should be known in an attempt to eliminate the problem effectively. We also perform the extensive checks, including reviewing the documentation of the providers, reviewing the payer policy changes, cross check the accuracy of coding, and also investigate the front desk procedures. By attacking these pivot points we will prevent subsequent denials and tune your reimbursement rates to the optimum.

    Rebilling / Claim Rebilling

    The moment we establish the root cause we take a corrective action on the affected claims and re-submitted them. This will involve Medicare, Medicaid, and commercial payers requirements, collaborations with the coding and billing departments and strict deadlines on resubmission. We also desire to submit clean and correct claims and be able to pass all regulatory and payer requirements in other words have a better opportunity to receive a payment.

    Formal Appeals Filing of Appeals

    Where we have situations of denials that may be dealt with through corrections, we prepare and file formal appeals. The appeals are made depending on the interest of the person paying the money, and they are effectively good and justifiable arguments used. We work on Level I and II appeals, we write medical necessity, we pack the supporting documentations, we render decisions to decisions. Having years of experience in terms of both commercial and government payer work we will be able to utilize our connections and achieve the optimal results in terms of reimbursement.

    Constant Monitoring and Tracking Revisit

    We make it a point to follow up strictly on all the denials and appeals until the time the same is resolved. There is accountability and transparency of the process and the regular update of payers and your staff members. The payers are kept in touch through the ability to communicate eagerly and in time, thus removing all the potential delays and misses.

    Effective denials resolution process guarantees extensive reimbursements and minimum wait time in the revenue cycle

    Identification & Categorization

    Data retrieval on denials on ERA, EOB and payer websites.

    Investigation & Analysis

    Looking into the reasons of denials and contrasting them to information in claims, coding, documentation and payer rules.

    Correction & Resubmission

    A change in erroneous information and resubmission of claims in line with the directions of the payers according to the time allowed

    Appeal When Necessary

    4.Filing and handing over appeals in the form of personalized letters and records and follow ups.

    Reoccurrence Prevention

    Identification of the patterns of the denial, propositions in the refinement of the processes and instruction of the personnel in the accuracy of the claims.

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    12

    Years Of Experienced in Medical Services

    The Advantages of NexCure LLC

    By selecting NexCure LLC as management partner,

    The list of benefits associated with associating with NexCure LLC to your practice is long:

    Reduce your revenue-cycle days and the collection/Accounts Receivable (A/R) days.

    Collect dollar claims that could have not been collected before increasing collection.

    Write off bad debt less by means of doing intensive follow ups and appeals.

    To increase the initial accuracy of a claim so that it denies.

    Keep you updated regularly on the status of denial resolution, on the status of appeals and payer specific reporting.

    • There is also strict confidentiality and compliance that removes the risk of audit.

    What Makes NexCure LLC Unique?

    When you choose NexCure LLC, you will always have dedicated team of experts who are keen to optimize your revenue cycle. Our team consists of the most experienced denial analysts and AAPC-certified coders which are provided with the latest technologies and can be incorporated into your existing system. All the information will be handled in a very confidential and compliance way and will protect you against threats of audit.

    Denials of Slaves We Debunk

    Effective denials resolution process guarantees extensive reimbursements and minimum wait time in the revenue cycle:

    Authorization Issues

    Ensuring that (before the claims are submitted) all the authorizations required are obtained.

    Non-Covered Services

    Making sure that the services provided are incorporated in the covers of the given insurance of the patient

    Coding Mistakes/Errors

    Providing appropriate Implementation of CPT/ICD-10 codes.

    Bundling/Unbundling Problems

    Agglomeration or deagglomeration of the services to an extent that is required.

    Modifier Errors

    Working with the abuse of modifiers.

    Late Filing

    Filing of claims on acceptable time

    Duplicate Claims

    Recognizing and resolving secret duplicate claims

    Conflicts in COB

    Orthodoxy in conflict resolution of COB

    Denials of Medical Necessity

    Procuring detailed records to establish medical needs

    Demographic Eligibility

    Ensuring correct patient information and eligibility verification

    Come Prosper with Us

    By the partnership with NexCure LLC, you will be able to have a sure partner in your attempt to work through the issues of reimbursement that characterize the medical world. It is our mission to make sure that you recover your lost revenue, get more cash flow and ease the billing process. Denial management and appeals services offered by us are full-service so that your practice can be able to survive amidst the continuously evolving world of healthcare financials.

    Call us now to learn how to transform your revenue cycle management, and bring your practice to a sustainable path of success with NexCure LLC.

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      Client Testimonials

      What Healthcare Providers Say About Us

      "Working with NexCure LLC has been a relief for my clinic. They took care of my credentialing process from start to finish, no delays, no confusion. I also like how they keep up with CMS quality programs and explain things clearly. Honestly, they’ve made my life much easier."

      Dr. Ayesha Rahman, MBBS

      "Before NexCure LLC, our billing was a nightmare — denials, delays, you name it. Their team stepped in and fixed our revenue cycle quickly. What I appreciate most is their guidance on MIPS reporting; they walked my staff through the requirements and we’ve already seen the results. Dependable and professional."

      Dr. James Whitman, MD

      "The attention to detail at NexCure LLC is impressive. They helped us get credentialed with several payers and made sure everything stayed compliant. Their support with HEDIS reporting boosted our scores, which directly benefited our contracts. I’m grateful for their hard work."

      Dr. Maria Gonzalez, MD

      "I’ve been very satisfied with the services from NexCure LLC. They keep me updated on payer rules and compliance, which is something many billing companies overlook. My billing cycle is smoother now, and their assistance with MIPS reporting has been a real plus. It feels like they are part of my team."

      Dr. Omar Al-Farouq, MD

      "Our practice needed someone who really understood billing and coding. NexCure LLC improved our collections and made the whole process less stressful. They’re straightforward, easy to reach, and they actually deliver on what they promise. I recommend them without hesitation."

      Dr. Alejandro Ramirez, DO
      12+

      Years of Expertise in Medical Billing & Revenue Cycle Management

      85+

      Providers Across Multiple Specialties Trust NexCure LLC Consultancy

      97%

      Clean Claims Rate Achieved on First Submission of Project Delivery

      15K+

      Claims Accurately Processed Every Month

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      (929) 587-3833

      Email address:

      Info@nexcurellc.com

      1500 N Grant ST #5001, DENVER, CO, 80203

      United States

      WhatsApp:

      (929) 587-3833

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