Strategies to prevent denials.
Denial management in healthcare continues to be a challenge— in part because the traditional way of working denials is time-consuming, costly, and prone to error. Denials eat up
as much as 3-5% of provider revenue, and according to some projections denial rates trend as high as 20%.
In healthcare today, the goal isn’t just making denial management more efficient through the right technology and operational changes. To avoid costly backlogs and lost revenue, providers need to reduce their overall denial rate and zero in on what’s really driving it and where there’s the greatest opportunity to holistically improve claims management and AR.
Both prevention and effective management of denials are key to profitability. Like all RCM challenges, the root causes of denials are fundamentally interconnected, and so let’s begin with three strategies to prevent denials. In part two of this series, we’ll explore four strategies you can implement to expedite denial resolution.
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