Denial Management

Key to Success: Submitting Clean Claims For Rapid Payment

If there's one thing we can’t stand, it’s time wasted on a predictable denial. Using both a 2+ million point rules engine and trained coders, auditing every claim is our first step in the billing process.

When a claim needs additional information or correction, the codes don’t pair or are not sufficiently specific, it is quickly routed to the right person, corrected, and then submitted electronically as a clean claim for timely payment. Once filed, we actively manage a four-point edit process, immediately correcting and re-filing claims if necessary so that they flow smoothly all the way to the carrier.

This process has earned MedFocus the "Gold Standard of Revenue Cycle" award, with a 99% clean claims rate.

More importantly, this robust process of pre-claim auditing has a significant impact on physician cash flow. By submitting a clean claim that is paid on the first pass, the days from date of service to payment can be reduced to the minimum processing time of each carrier - for some payers under 20 days.

In addition to reducing predictable denials, we go a step further to identify the reasons why claims require correction in the first place, and provide feedback, education and tools to our clients and their staff. They can then use this feedback to improve processes at the clinic or bring in MedFocus to provide education, improving and streamlining the revenue cycle proactively.

Measuring Performance

Starting the Revenue Cycle
Measuring Account Performance
Supporting Good Management

Will Outsourcing Work For Your Practice?

At MedFocus, we seamlessly integrate with your existing processes. 

Find Out How It Works Here

What Clients Say...


A note of thanks to MedFocus who has supported billing and reimbursement for our three clinics.  From the cost assessment process through implementation and ongoing services, staff members and the systems at MedFocus have provided us with excellent support.   


Multi-Specialty Surgical Practice