ZirMed launches new denial management solution for healthcare revenue cycle management

ZirMed®, a leading national revenue cycle management software and solutions provider to the healthcare industry, today announced the immediate availability of its new Denial Management and Decision Support (DMDS) solution, part of ZirMed's Analytics services. ZirMed Analytics is an advanced analytic engine that helps healthcare providers of all sizes better understand, correct, and receive payments and better organize the business to deal with payer- and patient-related revenue issues.

"One of the most challenging aspects of managing a healthcare business today is handling denials, zero-pays and audits. DMDS helps healthcare providers by analyzing vast amounts of claim and payment data to identify errors and areas for increased efficiencies," said Jim Lacy, Chief Financial Officer of ZirMed. "The magic of the Solution is to distil extremely complex and highly cognitive analytics into a simple and easy to understand set of tools that are consistent with healthcare revenue cycle workflow."

Industry statistics point to the negative impact of underpayments and unpaid claims. According to data from Physicians Practice magazine, denial rates can range from 5 to 20%. More alarming is that on average, 3.5 to 4% of providers' monthly billings are simply not paid.

ZirMed's denial management solution enables providers to collect much of this lost income at minimal cost. Denial Management and Decision Support is a subscription-based service that converts revenue cycle data into actionable information. It also establishes best practices that can be used to pursue continuous improvement.

For example, the Solution can quickly identify and prioritize unpaid claims, enabling administrators to assign appeal based on workflow needs. These key characteristics enable staff members to become skilled at working high dollar denials from particular payers, learning that company's idiosyncrasies and effectively pursuing redeterminations.

Other valuable reports in ZirMed's DMDS analyze patient payment data to determine the increase in consumerism and patient responsibilities within a provider's healthcare business. Providers are able to track changing patterns in co-pays, deductibles, and co-insurance with comparative data across payers enabling providers to strengthen patient collections tools and procedures. The broader benchmarking capabilities allow providers to compare performance -- whether financial or operational, such as coding practices -- within the business and to national averages.