Traditional claim scrubbing solutions do a fair job of preventing denials based on static claim formatting rules, but first pass denial rates today still average 15%-20%
Industry averages report that nearly 20 percent of all claims are denied, rejected or underpaid. And considering the cost to rework claims, not to mention even higher appeal costs, as many as 60 percent of returned claims are never resubmitted.
Each payer and plan may have different requirements increasing the complexity of the denial management process.
Making recommendations to manage denials, improve payment recovery and optimize billing
Glide solution optimizes the appeals’ management process analyzing administrative errors, medical policy changes or payer errors
Identify patient orders that require prior authorization (particularly high value drugs, treatments) based on Glide recommendations
Payer PA requirements change throughout the year a digital solution helps to keep staff up to date preventing denials
Identifies PA requirements for new treatments including drugs and procedures in real time.
Identifies new Payers and their PA requirements in real time
Supports knowledge sharing and financial counselor/billing staff training with a more consistent and dynamically identified set of PA and Claims rules
Glide forecasts turn around time and alerts when PA timeline is at risk
Supports new employees from day 1 and reduce turnover impact
Glide supports scaling PA efforts and centralization; traditional approaches rely on innate resource knowledge.
Includes volume, breakdown by payer, treatment, revenue, turn-around time, a prospective view, etc.