Denials Management

Outsourced Revenue Cycle Operations Experience Higher Denial Rates

Outsourced revenue cycle operations have lower performance on denial rates but other factors may still make outsourcing a viable option.

By HFMA October 4, 2018

Navigating Bad Payer Behavior in Emergency Services Billing

Weaver Hickerson and Tyler Williams propose three strategies to mitigate risk of denials in the emergency department in the wake of changes in insurer policy.

By Weaver Hickerson September 27, 2018

Ensuring the Revenue Cycle Gets a Clean Bill of Health

Health systems can reduce denials by using claims management tools, but their use must be supported by a commitment to ongoing process improvement within the organization.

By Eric Matson, MBA September 11, 2018

Integrated Revenue Cycle: Coordination Between Insurers and Providers to Ensure Revenue Accuracy

Working together, insurers and providers can realize mutual benefits of verifying the accuracy of information.

By Brandon Solomon August 29, 2018

Success in Proactive Denials Management and Prevention

Adopting a few key best practices can help healthcare organizations reduce denials.

By Glen Reiner August 29, 2018

Safety Net System Achieves $130M in Fiscal Improvements in 4 Years

Denials management and “keepage” strategies—keeping services within the health system—helped Maricopa Integrated Health Services improve its margins even in the face of a challenging payer mix.

By Laura Ramos Hegwer August 13, 2018

Ask the Experts: Denials Management Statistics

What metrics do CFOs consider important to support decision-making with respect to their denials management programs and health plan contracting?

By HFMA July 18, 2018

Your To-Do List When Health Plan Contracts Change

Six steps can help revenue cycle leaders manage health plan changes effectively.

By Lola Butcher July 12, 2018

Exemptions to Anthem’s ED Policy

Anthem will not deny an ED claim based on the prudent layperson standard if certain conditions apply.

By HFMA July 12, 2018

Ask the Experts: Physician Practice System Implementation

Is there a template for a new physician practice management system implementation plan geared towards denial management and collection modules?

By HFMA July 12, 2018
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