OurServices

---

1. Denial Management Services
2. Contract Audit Services
3. Refund Request Processing Services
4. Third Party Lien Services
5. Credit Balance Processing Services

 

1.	Denial Management Services
	Problem/Opportunity:   Most Health Systems lose between 3% and 5% of net revenues as a result of payment denials.
	Solution:   Outsource your denied claims to DMI, the foremost industry leader in capturing additional revenue. We offer the most comprehensive claim review process in the industry. At DMI, we have developed a unique, impressive electronic claim process for each and every type of claim problem. Our inside knowledge of the industry has been successfully proven to overturn even the toughest denied claims.
	Benefits:
	Foremost industry leader in identifying and capturing additional revenue for our clients. FREE initial consultation of over 45 different denied claim types including medical necessity, pre-existing conditions, reasonable and customary, and many more. DMI process claims and appeals for all payer types including Contractual, Indemnity, Government, Self-Funded, etc... DMI has the most comprehensive claim review process in the industry. DMI knows and understands the complexities of the administrative appeals process. Services do not cost anything until we are successful at getting your claim paid. DMI works on a "No Recovery No Cost" basis. On site Audits are available.
back to top

2.	Contract Audit Services
	Problem/Opportunity:   Increase contractual payments, decrease write-offs and negotiate solid contract terms.
	Solution:   Add additional revenue by hiring DMI to audit contractual payments/underpayments and identify contractual payment provisions which are being overlooked by the payer.
	Benefits:
	The potential results of a one time high dollar recovery. A team of health care professionals that are adept at focusing on specific areas of contracts that tend to cause healthcare providers most of their contractual underpayment problems. Audits give healthcare providers a leg up on renegotiating more profitable, less risky contractual provisions. DMI is an independent firm, with no potential for the payer to stall resolution of the issues. DMI can upon request, provide on site staff. Resolution to everyone's satisfaction.
back to top

3.	Refund Request Processing Services
	Problem/Opportunity:   Decrease the number of refund payments being returned to payers.
	Solution:   Outsource refund requests to DMI. Whether the refund request is due to patient ineligibility, COB issues, or processing errors, we have found that all refund requests require some combination of EOB, financial, insurance coverage, contract evaluation and review. This review is critical when determining a healthcare provider's duty to refund and DMI professionals are well seasoned in preserving the revenue on payments that have already been made.
	Benefits:
	DMI determines if a provider is required to refund through a proven electronic refund process. We have developed a unique set of response letters (both contractual and non-contractual) for each type of refund requests that a healthcare provider may encounter. DMI partners with our clients to become fully trained on their internal methods of form completion and documentation requirements to assist in completion of the refund process. We have the ability to provide our clients with reports documenting the savings that are realized. DMI is OIG compliant with respect to refund requests and overpayments.
back to top

4.	Third Party Lien Services
	Problem/Opportunity:   Increase long term revenue by filing hospital liens with responsible third parties.
	Solution:   Since the average hospital lien is not satisfied for at least a year, hire DMI to Protect your interests when it comes to auto and third party claims.
	Benefits:
	Professional consultation with all parties including the patient's attorney in a constructive, helpful, and effective manner. Experienced third party adjusters. Timely filing of all liens if the claim circumstances warrant one. DMI maintains constant contact with all necessary parties until the claim is resolved.
back to top

5.	Credit Balance Processing Services
	Problem/Opportunity:   Reduce credit balance backlog. Due to facility standards and OIG compliance, healthcare providers may from time to time need assistance meeting credit balance compliance goals.
	Solution:   We can perform credit balance reviews and resolution on all types of accounts, by payer class, by date, amount, etc. and can positively impact any credit balance backlog without interruption all the while making sure that you remain in compliance with established policies and procedures.
	Benefits:
	Prompt resolution of credit balances. DMI expedites credit balances audits with independent organizations hired by third party payers. DMI is OIG compliant. Full investigation and evaluation of each account that is in a credit balance status with immediate corrective action being undertaken. DMI completes and finalizes all credit balance paperwork to help bring the account to final resolution as soon as possible.

 

back to top