While most hospitals have ongoing efforts in denials prevention, very few can say they have cracked the code on denials.
Jim Lazarus, Managing Director of Strategy and Innovation, Revenue Cycle Solutions Division, The Advisory Board Company: Only about two-thirds of denials are recoverable, but 90 percent of them are preventable. Though prevention is not easy, fixing the root cause of denials has a much larger financial impact than overturning them. So how do you go about preventing denials?
For starters, set up a strong team of stakeholders across different departments and secure executive support. You should establish a monthly meeting where everyone can review and discuss current denial repots and make sure everyone on the team knows how to analyze report data and agrees on metrics. If the team lacks understanding of denials data, then you should invest in training that covers denial types, typical causes of denials and tactics for resolution.
Read my colleague’s blog post "An Ounce of Prevention Pays Off: 90% of Denials Are Preventable" to learn more about getting the right people together, to look at the right data, to move the dial on denials prevention.