When it comes to claims, the bottom line is, “A Clean Claim Gets Paid.”
Our claims processing team and proprietary system scrutinizes and scrubs submissions for likely errors, inconsistencies, and missing data.
PV Kent uses proprietary software in conjunction with industry leading Healthcare Management software to generate “clean claims” with no requirement to resort to a clearinghouse. Our tracking, follow up, and reporting modules are uniquely developed and customized to produce automated reports to allow us to monitor claims submissions in the most efficient manner.
PV Kent takes reporting one step further, our proprietary Denial Management software provides our clients with an in-depth analysis of their Denials for a selected period of time. Using this information, our providers can develop strategies to eliminate denials in the future. Our clients enjoy and benefit from this element of partnering with PV Kent at no additional cost.
Healthcare providers miss out on hundreds and thousands of dollars of potential revenue each year due to incorrect denials. These losses often occur because of contractual obligations, inadequate staffing, delays, and mistakes that are simply beyond the healthcare providers’ control.
PV Kent prevents and appeals denials with a level of attention that would be impractical for most healthcare providers. Even before a claim is submitted, our specialists discover and rectify potential problems caused by billing deadline discrepancies, coding errors, and lack of referrals.
In the instances where standard appeals procedures are unsuccessful, the Office of Medicaid or the insurance carrier, denies a claim for inappropriate reasons, PV Kent’s legal team offers advocacy and negotiation services, as well as litigation support. Our attorneys have the qualifications to appeal claims to the highest level, request fair hearings, and file complaints for judicial review with the appropriate court when appropriate.
These PV Kent characteristics trump the capabilities of our competitors and accelerate our client’s chances to be paid. PV Kent is nationally recognized and well known throughout the healthcare insurance industry. This edge forces carriers to carefully consider our claims submissions before issuing a denial and most often results in payment.