Ask the Experts: Managing Denials
I am considering creating a denials team and managing all the denials in patient financial services. How have you managed denials and achieved success?
Avoiding the Costliest Denials
Eligibility, outpatient medical necessity, and case management authorization continue to be three of the costliest denials. To avoid the negative effects of these types of denials, it is critical to implement an improvement process based on data.
How Carolinas HealthCare System Improved Transparency and Curbed Denials
New processes and automation helped the health system cut denied dollars in half for radiology services alone.Back in 2007, leaders at Carolinas HealthCare System, Charlotte, N.C., wanted to make their pre service processes more efficient and effective. Specifically, they wanted
Cash Recovery: How Richmond University Medical Center Repaired 6 Areas to Boost A/R
Richmond University Medical Center increased revenue by $19 million over a three-year period by improving preauthorization and registration flow and developing committees to work with payers, among other strategies.
Utilization Review Reduces Inpatient Denials
Covenant Health’s utilization review strategies have helped the health system recoup the difference between inpatient and observation status payments.
Ask the Expert: Rebilling Denials
What is the benchmark for number of days for rebilling after claims have been denied or rejected?
When and How ERISA Can Protect Providers in an Audit Situation
Here are some specifics providers should know about ERISA and commercial audits.
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