CLAIMS MANAGEMENT
Claims Management Services
Every rejected claim is rework, and every day of delay slows your cash flow. AviRex RCM's claims management service checks each claim against payer-specific rules before submission and manages rejections quickly, so more claims are accepted the first time.
WHAT'S INCLUDED
What claims management includes
Pre-submission claim scrubbing against payer and clearinghouse rules
Electronic submission through your clearinghouse
Daily rejection monitoring and same-cycle correction
Claim status checks on unpaid claims
Secondary and tertiary claim handling
Reporting on first-pass acceptance and rejection reasons
HOW IT WORKS
How it works
Scrub
Claims are checked for missing data, invalid codes, eligibility mismatches and payer-specific edits.
Submit
Clean claims go out electronically on a daily cycle.
Monitor
We watch clearinghouse and payer acknowledgments for rejections.
Correct and resubmit
Errors are fixed and claims are resubmitted quickly.
Track status
Claims that go quiet are checked rather than left to age.
REJECTION VS DENIAL
Rejection versus denial
A rejection means the claim never entered the payer's system because of a data or formatting error. A denial means the payer processed the claim and refused payment. Rejections are fixed and resubmitted. Denials are corrected or appealed through Denial Management.
WHY PRACTICES CHOOSE AVIREX RCM
Why practices choose AviRex RCM
- ✓Payer-specific rules rather than one generic checklist.
- ✓Daily cycle so errors are caught early.
- ✓Clear reporting on rejection patterns and fixes.
RELATED SERVICES
This service works closely with:
RELATED SPECIALTIES
We also support practices in:
COMMON QUESTIONS
Claims Management Services — FAQ
Claim scrubbing is an automated and manual check of claims for errors before they are sent to the payer, such as missing information, invalid codes or payer-specific rule violations.
It is the share of claims accepted and paid without correction or resubmission. A higher rate usually means faster, more predictable payment.
They move to our Denial Management process for correction and appeal.
Raise your first-pass acceptance rate.
Request a free billing audit from our team.