Contact Us Resolve Denials
ERN

Optimizing Physician Reimbursement and Reducing Denials

Physician groups operate in a fast-paced environment where timely patient care meets complex billing and reimbursement processes. ERN helps physician facilities navigate this complexity by ensuring fair and efficient reimbursements, minimizing denials, and keeping your cash flow healthy, so you can focus on providing high-quality care to patients.

Speak to an Expert

The Unique Challenges of Physician Providers

High Volume, High Complexity

Physician groups handle a high volume of patients with a broad range of medical conditions, from minor injuries to acute illnesses. This results in complex billing with varying payer requirements, from commercial insurance to government programs like Medicaid and Medicare. Without the right processes, this complexity can result in missed claims, delayed payments, and frequent denials.

Difficulties with Reimbursement for Non-Primary Care Services

Many physician groups struggle with reimbursement for services that are outside of the traditional scope of primary care, like emergency procedures or diagnostic testing. Payers often do not fully recognize these services under standard reimbursement codes, leading to underpayment or denial of claims.

Constantly Changing Regulations and Payer Mixes

The healthcare landscape is constantly evolving, and so are payer requirements. From regulatory changes to evolving payer policies, physician groups are often left scrambling to stay compliant. Multiple payers with varying requirements add another layer of complexity, leaving providers struggling to keep up.

ERN’s Recommended Solutions for Physician Groups

RevAssurance™ Appeals:

Denied claims disrupt cash flow and create administrative burdens for physician groups. Our RevAssurance™ Appeals process accelerates claim resolutions, secures timely reimbursements, and reduces administrative delays, allowing your team to prioritize patient care. Speak to an Expert

Revenue Cycle Consulting:

From underpayments to improper contract enforcement, hospitals often experience hidden revenue losses. ERN’s experts analyze payer agreements, billing workflows, and reimbursement patterns to help your hospital maximize recoveries, reduce A/R days, and improve cash flow. Speak to an Expert

Regulatory Compliance Training:

Payer requirements and healthcare regulations are constantly evolving, making compliance a critical challenge for physician groups. ERN provides comprehensive compliance support, regulatory training, and ongoing policy updates, ensuring your billing practices align with federal, state, and payer-specific requirements—helping you avoid penalties and revenue disruptions. Speak to an Expert

Specialized Claims Representation:

Physician claims often fall into gray areas between primary care, emergency care, and specialty services, leading to payer disputes and underpayments. ERN navigates these complexities, escalates denied claims, and fights for full reimbursement, ensuring that physician groups receive the payments they deserve. Speak to an Expert

Denial Prevention & Management:

Physician groups face frequent denials due to coding errors, documentation gaps, and payer-specific rules. ERN proactively identifies and corrects these issues before claims are submitted, significantly reducing denials, rework, and reimbursement delays. Speak to an Expert

Real Results for Physician Providers

“ERN has been a game changer for our urgent care center. Their expertise in handling urgent care claims has significantly improved our reimbursements and minimized denials. The ability to rely on their team has allowed us to focus on patient care without worrying about payment issues.”

- ERN, Client

Get Your Urgent Care Claims Handled Efficiently

Start with a no-obligation consultation to see how ERN can help streamline your urgent care billing process, reduce denials, and improve your financial outcomes.