OUR DENIAL RECOVERY & PREVENTION SOLUTIONS

AI prioritizes high value denials, which are then appealed by Industry Experts, Driving Significant ROI

Utilizing an AI-based approach, we employ machine learning models to optimize the denials management process by identifying claims with a high probability of successful payment and the greatest potential value. Then, a team of experts evaluates these claims and prepares top flight payer responses, resulting in more resolutions for our clients.

Impacted Claims:

  • Facility inpatient & outpatient

  • Pro-fee

THE PROBLEM

On average, about 24% of claims face denial during the evaluation and payment process–and this number is rising. This places a considerable financial strain on healthcare providers and can be a source of concern for patients who must cover out-of-pocket expenses. With highly manual denials management processes, most organization do not have enough time to make the proper selection of claims for rework.

Average Client Impact:

THE SOLUTION

Employing AI/machine learning, our exclusive algorithms comprehensively examine your claims and remittance data to pinpoint the underlying reasons for your denials. The fusion of advanced analytics and our industry-expert team enables us to offer solutions that reduce denials by up to $42%.

Denial rate reduction of between 15 – 42%

Our Benefits

Increased Reimbursement

Recoup more denied patient claims and realize about $5,200 per inpatient claim and $480 per outpatient claim.

Higher Appeal Success Rate

AI targets denials that have a high probability of a successful appeal, and as such, watch as your success rate skyrocket.

Improved Staff Productivity

With AI and TMD expertise on your side, our clients focus their efforts on other high value tasks.

217

We Strive to be an extension of your team.

Ask most of our clients, and they will tell you, TMD is such a joy to work with that “they are an extension of our team.”