Denied Claims Evaluation

Synapse has a first pass rate at over 90% because all claims are scrubbed and sent out to avoid denials. We will follow-up on all sent claims and appeal all denied and partially denied claims, so you collect what you deserve. We keep track of everything internally and place our tracking notes in your practice’s system.

  • Claims and pre-authorizations are submitted within one business day after receiving treatment notes, diagnosis sheets
  • Supporting documents for attachment are compiled and appropriate diagnostic narratives composed
  • Our Medicaid first pass approval rate is at 98%
  • Commercial first pass approval rate is at 90%.

 

 

Appeal / Re-submission of Insurance Denials / Denial Management

  • All denials are evaluated for appeals / re-submission as soon as EOBs are received
  • Insurance claim correspondences are responded to within one business day
  • Denials are tracked to identify patterns and prevent future recurrence.

Insurance Accounts Receivable / Pre-authorization Follow Up

  • Target is $0 for unpaid insurance claims over 90 days
  • We followup all AR and per-authorization over 30 days at least once month.