Denial and Rejection Analysis is a most important element in getting the provider paid. It's been noted that over 80% of the contested claims denials are turned out to be in provider's favor. But unfortunately, most of the denials aren't really contested due to time constraints or lack of follow up with the claims.

We at NSI analyze the claim remittance data for denial codes, delays, remarks, and the accuracy and completeness of the payments. We have a good understanding of managed care contracts between payers and the providers, which helps us in diligently following it up with every denial. We follow up on underpaid claims, understanding the reasons for underpayment, and then recovering revenues from the payers by taking steps to address those issues (resubmitting claims, appeals, etc.)