We Go Beyond Routine

Cardon's comprehensive Denials Management Program is designed to solve for cases that may fall outside your hospital's normal denials routine. Our Denial Management Program recovers tens of millions of reimbursements for our clients from payers all over the country.

We process denials from all payers including commercial insurance, workers' compensation, CHAMPUS, Tri-Care, Medicaid, and Medicaid HMOs. We pursue payment on unpaid and underpaid accounts, working to ensure that the hospital receives the highest possible reimbursement.

If an account goes "legal", Cardon's team of attorneys take quick action so that the best outcome is achieved on each denied account.

Legal action consists of two stages. The first stage involves sending a legal demand for payment from the non-compliant payer. We offer this to our clients as a value-added service and it falls under our ordinary Denial's Management rate. The second stage involves actually filing suit against the payer that has denied reimbursement. Cardon's attorneys will file suit on both ERISA and non-ERISA payers that have denied payment. By offering legal reinforcement, Cardon ensures that a hospital's claims will not be ignored by payers when a good basis for appeal exists.

We often begin where your facility's program leaves off. Denials management at most healthcare facilities means correcting mistakes that result in erroneous denials.

Our program work on reversing denials is based on our uniquely diligent review of the underlying facts, contracts and coverages.

Contact us to learn how we also utilize our field staff to enable patient involvement, and how our Denials Management & Appeals Solutions cover the industry's broadest range of payer categories and types of denials.