Denial Triage & Accounts-Receivable Follow-Up
Administrative follow-up designed to improve visibility around denials, outstanding balances and payer responses while ensuring issues requiring qualified review are escalated appropriately.
Support May Include
Depending on your agreed scope, support may include:
- Categorization of denials using client-approved rules.
- Administrative correction and resubmission support where permitted.
- Follow-up on outstanding balances.
- Documentation of payer responses.
- Identification of recurring administrative issues.
- Escalation of issues requiring qualified review.
Service Boundary
Issues requiring clinical or coding judgment are escalated.
- Coding issues requiring judgment are escalated.
- Documentation issues requiring clinical review are escalated.
- Medical-necessity decisions remain with qualified professionals.
- Appeals requiring qualified review are escalated.
- Maono does not independently determine clinical justification.
Common questions.
How are denials categorized?
Denials are categorized using rules, workflows and categories approved by the client.
Can Maono correct and resubmit claims?
Administrative correction and resubmission can be supported where the issue falls within the agreed scope.
What happens when a denial involves coding?
Coding issues requiring professional judgment are escalated to the appropriate qualified team member.
Can your team follow up on outstanding balances?
Yes. Administrative accounts-receivable follow-up can be included within the agreed workflow.
How are payer responses tracked?
Responses can be documented within the approved client system or reporting workflow.
Do you prepare clinical appeals?
Anything requiring clinical, coding or medical-necessity judgment must be handled or reviewed by qualified professionals.