Do you struggle with your current denial management process? For billing managers, it’s easy to understand how tough it can be to handle denied claims. Denied claims are sometimes hard to detect, and they serve as a constant drain on your revenue. While you’re trying to find out how you can raise the number of claims your practice processes, you have to consider how many claims get denied by your payers. For those who process hundreds or thousands of claims each week, even a tiny fraction of claims being denied can severely harm your bottom line. This is when it’s helpful to have automated denial management. Find out how automated denial management can help you close the gap that comes between denied claims and more profit for your practice.
Why You Need a Denial Management Plan
When healthcare organizations don’t have a defined strategy for denial management, there’s a higher chance for them to receive denied medical claims. It’s been determined that roughly 1 to 5 percent of medical claims get denied on their first submission. Denied claims also cost triple the money to get reworked than it would cost to submit a clean claim initially. Challenges only pile up over time as you add more payers and specialties to your practice’s revenue cycle.
Automating Your Denial Management Workflow
There are still a lot of providers who use manual claims denial processes. You don’t want to deal with human error if you can help it. The best way to resolve medical billing mistakes is to catch the mistakes before they take place. For larger healthcare businesses, especially, it will take more than a manual process to handle the large number of claims that come in each day. Automation integrates perfectly into your denial management plan using three phases: pre-denial, post-denial, and advanced reporting.
- Pre-Denial Management: This is when you put technologies in place to detect all possible causes for denials and segment those denials so that the proper solution is put into effect.
- Post-Denial Management: This involves recovering all of your hidden revenue and minimizing the impact of your denials by the main causes and sources of your denials.
- Advanced Reporting: With the help of top-notch data analytics, you can find out whether or not you have enough staff members working on your denials. You can also determine if you don’t have a working process or if there are any problems somewhere else.
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