Before using Rivet’s denials solution, Shantelle Knight at Tanner Clinic said she’d have to work 20 denials before seeing any sort of trend as to why a certain type of denial occurred.
“Now, with Rivet” she said, “I can easily spot denials trends. I can look into a specific code or denial reason and instantly see 20 claims with that code or denial reason. I can take immediate action to fix the problem on the front end and prevent denials from even happening.”
Shantelle loves that she can assign denials out and track progress within Rivet. She uses Rivet’s instructions portion to leave tips and tricks for specific types of denials so her team can problem solve without her help. She saves things like policies and provider rep contact info so her team has everything they need when they click on the claim that needs to be reworked. And, Shantelle said, she uses the filters and saved views in Rivet to stay on top of denials that are 0–30 days old.
“We’re so on top of our denials,” she said, “we’re getting claims off of our reports before they can even hit our reports. We’re no longer seeing denied claims become 180+ days old.”
Back before they used Rivet, the Tanner Clinic team sent lots of claims with questionable insurance payment accuracy to Shantelle for further inspection. Shantelle said approximately 80% of those claims only needed the proper write-off applied since insurance payers had, in fact, paid correctly. But since the allowed amount varies based on the insurance and provider type, there’s no way to know about correct payment without a great deal of effort from people like Shantelle.
But Shantelle’s workload changed when she started using Rivet’s underpayments tool. “We now have intimate knowledge of our contracts and what providers should be paid. Rivet helps us minimize our workload and increase efficiency so we’ll get paid what we deserve.”
Shantelle is the Insurance Processor Services Trainer at Tanner Clinic, where she teaches her team how to manage portions of the revenue cycle, and now, she said, she also teaches them how to use Rivet.
Tanner Clinic has 140+ providers with 30+ specialties in 12 locations throughout Northern Utah.
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