Washington & West, LLC is organized and staffed to actively pursue the recovery of funds from health insurance payors who have wrongfully denied claims, underpaid claims, or who are extremely slow to pay. Our clients are hospitals, hospital systems and specialty medical groups. In order to provide the industry's most effective service to these clients, our staff consists of attorneys, physicians, physician assistants, registered nurses and business office recovery specialists. Our services are designed to meet the dynamic needs of our customers: from payor contract review to the complete outsourcing of denials management. For more information on our programs and services, please click on one of the following choices or Contact Us.     Our core business is helping healthcare providers get paid for the good and valuable services that they have rendered to patients. We have further defined our market niche as those claims that have been denied for payment, been underpaid by an insurer, or where a payor has been extremely slow to pay. We are not a collection agency and do not handle any accounts in which the payment balance is due from a patient.     Denials Management Outsourcing Solution We recognize that many hospitals and health systems have a system in place to handle denied claims. However, as hospitals are being expected to do more with less, many are making the decision to move resources from claims and denials management to clinical services. The thought process is valid for daily hospital operations, but without someone tracking, trending, and appealing denials, the problem could get worse. If you are in this or a similar situation, Washington & West can provide a Denials Management Outsourcing Solution. We are available to take over and operate an entire denial management program on your behalf. Since our fees are constructed on a contingency basis, there is only a limited risk to you. For more information on our Denials Management Outsourcing Solution, please Contact Us. Supplemental Recovery Efforts We recognize that many hospitals and health systems have a process in place to handle denied claims. Our services, then, are designed to supplement internal recovery efforts and to serve as an additional tool in capturing otherwise lost revenue. Our experience has shown and our clients agree that merely the volume of denied claims can overwhelm a hospital's insurance recovery and appeals process. Further, an in-house operation may not have the specialized resources or experience readily available to fully exhaust all dispute remedies, should such action be needed to bring these claims to a successful conclusion. If your internal appeal system is experiencing less success than in the past, is being overwhelmed by the volume of denials, or is experiencing new types of denials, please Contact Us about our Supplemental Revenue Efforts and how you will benefit from our involvement. Denials Management Consulting Our business is understanding the world of healthcare payment and providing denial resources & revenue recovery solutions to our clients. Because we are in many institutions across the country, and we are appealing thousands of cases each year, we have a unique opportunity to assess which strategies and tactics are working and which are not. If you believe your denials management and appeals processes are working okay, perhaps your hospital would benefit from having a denials management expert take a look at your operation. While we don't offer a guarantee, you will be surprised by the positive impact we can have on your success. For more information on our Denials Management Consulting Services, please Contact Us.     The foundation of every successful denials management program is the payor contract. While you may have many contracts that seem to be similar, each is unique in a special way.     Review of Contract The staff of Washington & West has significant experience reviewing and analyzing payor contracts. More importantly, we can identify those terms & conditions as well as definitions contained in a contract that will substantially limit your ability to overturn a denied claim. Payor Contract Review Services are performed on an hourly basis. We are please to provide this service regardless of whether you refer us a single contract or all of your contracts to review. For more information on Payor Contract Review Services, please Contact Us. Rewrite of Contract The staff of Washington & West has significant experience reviewing and analyzing payor contracts. More importantly, we can identify those terms & conditions as well as definitions contained in a contract that will substantially limit your ability to overturn a denied claim. More importantly, we have developed model language that can be used to transform your contract from an impediment to payment to a stimulus for fair, reasonable, and predictable reimbursement. Payor Contract Rewrite Services are performed on an hourly basis. We are please to provide this service regardless of whether you refer us a single contract or all of your contracts to review. For more information on Payor Contract Rewrite Services, please Contact Us. Negotiation The final step in the contracting process is to negotiate the final agreement, recognizing that there will be give and take between the parties. Washington & West staff members are available to participate as a member of your managed care negotiating team. This effort can be accomplished either face-to-face with the other parties, or as a reference member that is a phone call away. Payor Contract Negotiation Services are performed on an hourly basis. We are please to provide this service regardless of whether you refer us a single contract or all of your contracts to review. For more information on Payor Contract Negotiation Services, please Contact Us.