4 Ways to Improve Your Denial Management Process

Managing claim denials is crucial for the ongoing success of healthcare organizations. Establishing an effective denial management process can significantly improve your revenue cycle and reduce your number of future denials.

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Topics: Denial Management

Why We Love Denial Management Solutions—and You Should Too!

If you’ve been following our blog, it should be of no surprise that all of us here at VARO love denial management solutions. We eat, sleep, and breathe these solutions because:

  1. They’re easy to manage (with the right process)

  2. They reduce lost revenue (with the right support)

They also help reduce the stress, and constant back and forth between insurance carriers and hospitals. In fact, by this point, you might be used to that hassle—but with a proven solution at your fingertips (especially one you’re able to outsource), your organization will reap lucrative rewards.

So you know why we love denial management solutions…

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Topics: Denial Management

5 Questions You Need To Ask Yourself to Avoid Insurance Claim Denials

According to the Medical Group Management Association, high-performing medical groups have a four percent claims denial rate. If your denial rate is over 4%, don’t blame your payers; instead, look at your business’s processes. Timing problems, manual mistakes, and input oversights may be causing most of the denials. 

Something you could do before submitting claims to make sure they're clean is ask yourself the following questions! Clean claims = less denaisl. Print them out and post them to your bulletin board!  

Monitor these five issues to improve your billing approach and decrease your denial rate.

1.    Is the Claim Legible?

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Topics: healthcare receivable management, Revenue Cycle Management, Denial Management, Denials, Claims, Insurance Claim Denials

Denial Management or Denial PREVENTION – either way, it’s changing!

It seems as if there is always something changing within the healthcare field these days. Denial Management (or as a nice woman told me she likes to call it, “Denial Prevention”) is no different, and has its own struggles in this ever changing field. A lot has changed, and will continue to do so as we try to optimize how we process denials.

The way your facility handles denials is very important for reimbursement. Duh, right? It used to be that someone in this department (or at least someone who knew the job) would get a letter from the insurance company stating why it was denied. After that, the appeals process would begin. This tied up funds or reimbursements for quite some time and would involve the investment of copying an entire chart and having physician advisors review that chart. This process is very costly and time consuming. Medicare has decided to hold facilities accountable for what they do.

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Topics: Denial Management