For over 20 years, our expert denials specialists have successfully recovered significant revenue and provided client specific details to prevent future denials.
At McBee, we specialize in managing denials and offer a comprehensive suite of services extending beyond just processing claims, including a service devoted specifically to coding denial management. Our approach to denials management includes providing valuable guidance on preventive measures. Our team of denial management service experts zero in on the root causes of denied claims eligible for appeal, craft compelling appeal letters, and aggressively pursue payment for overturned claims. Additionally, our denials management team delivers recommendations and reports on trends, facilitating improvements in documentation processes, leading to operational enhancements that can reduce the overall number of claim denials over time, keeping you efficient and profitable.
With a track record of enhancing cash flow and profitability through expertly executed denial management, we’re a denials management company that has successfully appealed thousands of recoverable denials annually and proudly partner with some of the largest hospitals and health systems nationwide.
Detailed metrics to categorize reasons for high denial rates and quantify the financial impact
Actionable suggestions to enhance the denials management workflow
McBee has been an exceptional partner to Texas Children’s for the past 6 years. During that time, they have been essential to helping overturn denials and share insights on denial prevention strategies. Due to their quick recognition of an opportunity, we were recently able to secure a multi-million dollar win for the organization.
McBee supports our DRG downgrade denials and appeals management. Their approach has been extremely comprehensive and successful. They craft compelling and thorough appeals. This has resulted in an impressive overturn rate for our enterprise. In addition, they deliver significant and insightful data on every case they review. As such, we utilize that data to modify operations to minimize future denials.
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The McBee Advantage
When you partner with McBee, you are partnering with a firm that has the capacity to handle the high volume of denials and help address lost revenue that can accrue at year-end and during regulatory audits.
Data Analytics
Our proprietary data analytics track documentation trends to identify areas to improve and create the basis for our tailored educational sessions. Our revenue cycle management services provide a comparative analysis of your claims and payment data, leading to valuable insight on the correlation between clinical documentation and denied claims.
McBee’s denials management service can assist with:
- Medical Necessity
- DRG downgrades
- Line-item denials
- 1st, 2nd and 3rd level appeals
- External appeals such as State Fair Hearings and Administrative Law Judge (ALJ) hearing
Restructuring Processes
Additionally, McBee can be your partner in restructuring your in-house denials management process. With extensive understanding of payer tendencies, denials management processes and overall industry knowledge, McBee can assist you in understanding why claims were denied, align team workflows and implement denials prevention measures and solutions.
Evidenced-based industry criteria cited to develop the most persuasive appeal letters
Registered nurses and certified coders with deep experience in patient care
Our staff has an average of 20+ years of experience in diverse specialty areas
$74M
Recovered in the last two years
$27M
Recovered for South West hospital system after holding insurance responsible for violating appeal response deadline
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Frequently Asked Questions About Denials Management & Appeals Service
Denials management involves identifying, addressing, and preventing claim denials by payers to ensure proper reimbursement for healthcare services provided, with the process usually being done either in-house by a dedicated team or outsourced to a denials management service like the one provided by McBee.
Effective denials management helps healthcare providers recover lost revenue, improve cash flow, and maintain financial stability by addressing and preventing claim denials.
McBee identifies the root causes of denied claims, crafts compelling appeal letters, and aggressively pursues payment for overturned claims. They also provide recommendations to prevent future denials. Learn about overcoming denials and appeals through 5 action items.
McBee can assist with medical necessity denials, DRG downgrades, line-item denials, 1st, 2nd, and 3rd level appeals, as well as external appeals like State Fair Hearings and ALJ hearings.
McBee provides actionable suggestions to enhance the denials management workflow, leading to operational improvements that reduce the overall number of claim denials.
McBee offers comprehensive denial management reporting, including detailed metrics to categorize reasons for high denial rates and quantify their financial impact. Learn more from our webinar on how to be prepared for additional documentation requests (ADRs).
With over 20 years of experience, McBee’s denial management service is effective due to their expert team, compelling appeal strategies, and comprehensive reporting, resulting in a high rate of overturned denials.
Yes, McBee can partner with your organization to restructure the in-house denials management process by aligning team workflows and implementing denial prevention measures and solutions.
McBee has recovered significant revenue, including $74 million in the last two years, and $27 million for a hospital system by holding insurance responsible for appeal response deadlines.
McBee’s team includes registered nurses and certified coders with over 20 years of experience in diverse specializations, ensuring expert handling of denials and appeals.