Denials Trending, Recovery and Prevention

Our customized solution enhances your denials management program – trending denials to find areas of opportunity, then collaborating with your organization to design and implement a denials prevention strategy. When required, we also act as an extension of your staff to focus on collection and resolution of problematic or denied third-party accounts.

Payor Audits

Payor audits can consume vast amounts of your time and financial resources. C3 takes on this burden by communicating directly with the payor or third-party auditor on your behalf. Our highly skilled and seasoned team members will work payor audits remotely to prepare defense, or come on-site when necessary to meet with the payor and your team.

Zero Balance Account Review

We collect lost revenue associated with closed accounts by identifying and re-billing contractual underpayments or denials. Our proprietary software provides a comprehensive analysis of contractual terms and ensures that payers comply with established agreements. As issues are identified in the audit process, we provide proactive follow-up, payor communication, and settlement arrangements to resolve issues and collect lost revenue.

Utilization Review and Management

Our nurses are experienced in providing initial and concurrent reviews in all care settings. They are proficient in evidence-based criteria platforms and are up-to-date on the latest Medicare and Medicaid regulations. Our teams will fully manage your utilization review department to ensure optimal staffing ratios, clear operational policies, timely appeals and regulatory compliance.