1. What is Denials?
Rivet's Denials product brings efficiency in helping your team identify and appeal insurance denials. We do this by working with your existing claims solution and practice management system to ingest payer claim data and organize automated worklists. Layer on your team's knowledge base and workflow status indicators and everyone is on the same page.
From the main home page select the Denial Tile or Navigate: Denials > Dashboard
2. Automated user assignments
Assign denied claims based on single, or multiple criteria. Does your team work denials by the payer? Is a payer split alphabetically (ex: Medicare A-L)? Are denials split by the provider? Are denials worked by type of denial (ex: Anne works coding and medical necessity denials while Nancy works eligibility denials)? You now can layer on singular or multiple criteria to automatically assign denials to your team.
3. Dynamic instructions
Help your team standardize workflow and help new team members ramp up their expertise on denials. You can build out sets of instructions that prescriptively tell an individual what steps should be taken to resolve an open denial. By using all relevant claim data, you can create very specific workflows to resolve more denials, faster.
4. Worklist/workflow management
Don't get lost in the volume. Rivet will automatically group and prioritize your denials worklist so you are working on the biggest impact groups first. You'll also be able to see all the denials with the same criteria such as payer, procedure code, denial reason code, and remark code. This allows you to multiply your productivity based on identical root causes.
5. Automated recovery detection
Rivet is continually fed updated adjudication information so if an appeal is submitted and paid, we'll reflect this in the product so that you can see all of the dollar amounts that have been successfully recovered.
If you have any additional questions about the Claim Resolution feel free to chat in or email at support@rivethealth.com.
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