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Stop Medical Claim Denials Before
They Occur

As hospitals, health systems, and independent practices strive to overcome critical staffing shortages and push towards an increased focus on patient experiences, they need more efficient and effective processes and policies to maintain financial health.

For 34 years, SSI has been committed to providing hospitals and health systems with proven revenue cycle management solutions that help prevent denials and provide a platform for scrubbing and processing institutional and professional medical claims.

 

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The SSI Group LLC’s clients experience a 98%+ first-pass payer acceptance rate (clean claim rate). How do we do it?

INDUSTRY’S MOST COMPREHENSIVE EDITS SUITE built over 34 years and includes payer-specific edits with hundreds of direct payer connections

ELIGIBILITY STRATEGY, which includes a set of pre-billing eligibility edits that capture potential changes in insurance before the claim goes to the payer

ATTACHMENTS STRATEGY, SSI software identifies where attachments may be required, and monitors claims so that denials can be prevented and/or appealed when attachments are required

DENIAL MANAGEMENT WORKFLOWS that allow you to assign specific claims to specific users based on experience and/or expertise

In addition, clients can identify and monitor the impact of denied medical claims, view denial trends, manage denials, and determine root causes by accessing the most granular claim and remit data.

Custom work queues automate and simplify the follow-up process and allow staff to easily organize, prioritize, and manage underpayments and denials. With robust reporting capabilities and activities based on user and/or role, organizations can appropriately divide work based on staff experience and expertise and track custom KPIs to determine the success of their efforts to increase net revenue.

More Than a Clearinghouse

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Denial Research

Easily categorize and establish root cause assignment for denials.

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Workflow Development

Develop a streamlined claim and line-level denial workflow.

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Remit-Claim Linking

Establish a method of manually linking remits to medical claims not matched initially.

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Denial Auto Assignment

Auto-assign denials to users based on denial type.

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Follow-up & Appeal Filings

Incorporate follow-up and timely appeal filing deadlines into your workflow.

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What Our Clients Are Saying

“Even aside from the clean claim rate, it’s just good to have everything in one place. You can see your paper claim percentage. So if for some reason, we see that go up, we’d ask, ‘Are our payers set up appropriately?’ Whereas historically, we’d ask, ‘We’re getting all these paper claims printed, and we’ve seen it for two or three weeks. Can someone tell us what’s going on?.”

Jana Danielson, MS, FHFMA, Executive Director of Revenue Cycle, Nebraska Medicine

“SSI and their team are excellent business partners and go above and beyond to help us.”

“SSI and their team are excellent business partners and go above and beyond to help us.”

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Claim Denial Management: Key Strategies to Help You and Your Organization Make Improvements

Stopping medical claim denials before they even have a chance to occur is the best way to ensure hospitals and providers receive correct payment quickly and efficiently. Download this free eBook to discover denial prevention strategies and industry insights from the experts at SSI.

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Why Choose SSI?

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34 Years of Revenue Cycle Management Software Excellence

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Results-Driven Process for Expediting Time to Payment

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Highly Experienced Revenue Cycle Experts at Your Service

About The SSI Group, LLC

Since 1988, SSI has been in the business of ensuring healthcare providers are paid timely, efficiently, and accurately. SSI’s product suite delivers an enhanced collections process from payers and patients.