DENIAL MANAGEMENT
In order for hospitals to be successful in reducing denials and revenue leakage, a concurrent approach to managed health care’s operational requirements is critical. VERACITY™ integrates the daily operations that have a direct impact on maximizing reimbursement, reducing denials, and tracking contract compliance. VERACITY™monitors patient care requirements and patient account requirements through each of managed health care’s required clinical and business steps.
VERACITY™ functionally links managed care business operations, patient access and accounting requirements under managed care, and concurrent Case Management/UR operations into a singular managed care information process platform. In-house information is passed multiple times daily to monitor operational compliance and all payer thresholds. Automated interdepartmental worklists are triggered by contractually defined rules or criteria set to meet guidelines regarding level of care, contract thresholds (authorized days, stop-loss, dollars) and patient review requirements.