Denial Management

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7 Steps to Success in Proactive Denials Management and Prevention

January 4, 2024

7 Steps to Success in Proactive Denials Management and Prevention Kyle Sherseth  |  Vice President – Revenue Cycle Solutions     In 2021, denials rose to an average 11% of all claims, with the cost of denials increasing 67% year over year1. This translates to 110,000 unpaid claims for an average-sized health system. It’s no…

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Acute care facility leverages expert resources to successfully appeal clinical denials

November 11, 2022

Acute care facility leverages expert resources to successfully appeal clinical denials. Case Study Acute care facility leverages expert resources to successfully appeal clinical denials. A 200-bed, $509M NPR client lacked resources able to review and resolve their large volume of denials, nor did they possess the skill set to determine plausibility of certain clinical appeals.…

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Safety net system transforms denial backlog into $20M+ gain

November 11, 2022

Safety net system transforms denial backlog into $20M+ gain. Case Study Safety net system transforms denial backlog into $20M+ gain. This 800-bed, $532M NPR safety net system struggled with retaining the resources needed to address an immense denial backlog and lacked visibility into their root causes. This threatened cash collections and financial viability of the…

Denials: An Ounce of Prevention is Worth a Pound of Revenue

February 15, 2021

Denials: An Ounce of Prevention is Worth a Pound of Revenue The old saying, “An ounce of prevention is worth a pound of cure,” rings especially true when it comes to health care claim denials. To circumvent costly rework, which typically occurs at the back of the health care revenue cycle, today’s savvy health care…

The Mid Revenue Cycle: Key to Reducing Claim Denials

January 2, 2021

The Mid Revenue Cycle: Key to Reducing Claim Denials Are you experiencing documentation and coding errors? Do you suspect you may be under- or over-charging? If so, your denied claims rate may be hurting your revenue cycle. Incorrect or incomplete documentation and coding in the middle of the revenue cycle result in more denials and…