Denials Management Software and User Productivity Module

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Denials Management Software with Integrated
Alerts and Intelligent Work Queues
Bridgestone Healthcare Revenue Managements
Web-based Denials Management Software (WEB-DMS)
includes a robust and easy to use Work Flow
module that includes automatic system
Alerts. With WEB-DMS Denied Charges are
automatically routed to the appropriate work
queue for resolution. Work queues can be based on
any criteria necessary. All Work Queues include
ALERTS. Alerts set-ups are a feature in the
system that typically is accessed by the
supervisory staff. What is an Alert? An Alert
is where the Denials Management System identifies
any trend or action that is considered unusual
activity. An example could be your facility has
during an average 30 day period about 100,000
in Denied Charges for ANSI Code 27, which is an
Eligibility related denial code. If in the
current 30-day period the system identifies
130,000 in Denied Charges for ANSI Code 27 an
Alert message will be sent to the Work Queue
user, the users supervisor and the Bridgestone
staff. This will inform the staff that there is
some unusual activity in the system. The intent
is to inform the appropriate staff at the
earliest date possible there may be a problem in
the system. Alerts can be created using any logic
necessary. Here are some more real examples
Chemo drug denied charges exceeding 30,000 in 15
days. Claims within 45 days of Filing
Limit. Medicaid has 30 more Denied Charges than
during an average 30 day period. The number of
Authorization Related Denied claims is 25 higher
in the current 30 day period than the average 30
day period.
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Alerts are created using any of the data elements
in the system. With Alerts in place the staff
and management will always be notified at the
earliest possible moment when there is any
unusual trend with Denied Charges. For more
information contact Wayne Gill at
sales_at_bridgestonehrs.com or (619) 920- 6147.