One of the largest academic medical centers in the northeast commissioned AGS Health to provide coding denial management services. With inventory building, they needed a partner that could scale quickly and identify the root cause of their growing denials problem.
Challenge
- Payors delay and deny claims for patient services
- Denial management and inventory
Solution
AGS achieved a 72% decrease in the denial inventory within 6 months and achieved net collections of $1.4 million on a balance of $2.7 million. Additionally, the health system achieved a 40% cost savings from outsourcing coding denial management to AGS.
72%
decrease in the denial inventory within 6 months. AGS reviewed frequently denied CPTs for possible modifier appendage, as well as nonspecific/non-covered diagnosis based on CMS guidelines.
70
front-end coding fixes. AGS closely partnered with the health system and made programmatic, actionable recommendations on creating modifications within their practice management system.
$4M
net revenue impact. The health system achieved a 40% cost savings from outsourcing coding denial management to AGS.
