Claims Management
Support throughout the claim lifecycle, from preparation and submission to follow-up and resolution.
Service Overview
Submitting a claim is only the first step. UR RCM CONSULTANCY LLC provides active claims management that tracks claims continuously through clearinghouse receipt, payer acceptance, adjudication, and settlement, resolving front-end edits before they turn into stagnant aging.
What We Do
Our specialists take hands-on operational responsibility across each specific task in the workflow.
Pre-submission claim scrubbing against national and local coverage determinations
Daily 277CA claim acknowledgment review and rapid rejection correction
Payer electronic attachment and medical records submission coordination
Secondary and tertiary claim crossing with primary EOB coordination
Clearinghouse rule tuning to address repeat payer edits
Active tracking of pending and suspended claims within payer processing queues
How It Works
Step-by-step execution designed to integrate smoothly with your existing practice routines.
Payer-Specific Scrub
Claims are audited against up-to-date payer clearinghouse validation rules.
Secure EDI Transmission
Claims are routed through secure 837 EDI pipelines to commercial and government payers.
277 Status Monitoring
We monitor EDI status responses within 24 hours to intercept initial payer-level edits.
Adjudication Follow-Through
We track claims through payment determination, addressing requests for additional documentation immediately.
Key Benefits
Fewer First-Pass Rejections
Rigorous pre-submission validation ensures claims reach adjudicators cleanly.
Accelerated Turnaround
Prompt responses to clearinghouse rejections shorten days in accounts receivable.
Secondary Payer Coordination
Timely crossing to secondary insurers prevents patient balance confusion.
Why It Matters for Your Practice
A claim delayed at the clearinghouse level is a claim unpaid. Proactive claims monitoring prevents submissions from languishing silently in payer queues.
What You Receive
- First-pass acceptance rate tracking
- Clearinghouse rejection resolution log
- Weekly adjudication progress updates
Frequently Asked Regarding Claims Management
Strengthen Your Claims Management Operations
Contact UR RCM CONSULTANCY LLC today for a confidential review of your current workflow and billing requirements.
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