Key Strategies for Performance Improvement
Developing engagement across a hospital or health system encourages collaboration and problem solving on costly claim denials.
4 Clinical Reasons for Denials
Denial prevention efforts should focus upstream in the revenue cycle, starting with patient status and continuing through documentation practices, coding, CDI, utilization review, and charge capture.
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.
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.
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.
hfm Magazine: September 2018
The September 2018 edition of hfm explores people and culture in healthcare finance, focusing on performance improvement, academic-community relationships, and care delivery.
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.
Success in Proactive Denials Management and Prevention
Adopting a few key best practices can help healthcare organizations reduce denials.
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.
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?