SERVICES

Edit Reconciliation & Denial Management

Are You:
  • Struggling to keep up with CCI edits?
  • Confused over which modifier to use/not use?
  • Hearing your CFO complaining about unbilled claims?
  • Concerned about compliance & 3rd party audit risk?

    • We can help!
    HIP (866) 622-8300



    HIP Denial Management & Edit Reconciliation Auditors possess a hybrid coding and billing skill-set which uniquely qualifies us to resolve NCCI Code Pair Edits, Medically Unlikely edits (MUE's), as well as Custom edits.

    HIP auditors work from a remote location and are proficient with most major claim scrubbing software programs and NCCI code checker tools.

    HIP only hires credentialed coding and billing experts to provide the client with the best quality service available.

    Denial rates are on the rise and represent a substantial financial drain on health care organizations. HIP Denial Management & Edit Reconciliation services increase payment recovery and "get the bill out the door" for clients by mobilizing quickly to reduce your backlog.

    Denial Management:

    • Denial Resolution Management
    • Government Appeals Management
    • Root Cause Analysis of all denials
    • Denial Appeal Management
    • Coder turnover

    Claim Edit Reconciliation Services:

    • CCI Scrubber Edit Resolution Management
    • Prompt action to claim rejections from facility based scrubbers
    • Correction of failed claim to release to payer


    NCCI Code Edit Resolution
    Credentialed/Experienced hybrid Coder/Billing staff review and resolve Claims for claim submission
    Denial Management
    Credentialed/Experienced hybrid Coder/Billing staff resolve denied claims for resubmission
    Documentation Audits
    Periodic audits conducted retrospectively to assess CDI impact