Hospitals and health systems are constantly looking to decrease claims denials. One area of opportunity involves Medicare and Medicaid managed care plans.
Jeff Means and Sara Roberts of Colburn Hill Group: Managed Medicare and managed Medicaid tend to have significantly higher rates of initial denials (remittances denying line items or entire claims) than commercial or government payers. Tracking these denials in detail is critical. Build a denials management scorecard and a cross-functional team to implement process changes to prevent denials in the future.
To learn more about managed care, access this story from Becker's Hospital Review.
If you would like to share your RCM best practices, please email Kelly Gooch at kgooch@beckershealthcare.com to be featured in the "RCM tip of the day" series.