Tune into this episode and learn about denial prevention strategies from Colleen Goethals, the Vice President of Mid Revenue Cycle at Xtend Healthcare. Colleen helps us explore the current denial rate, how provider executives can prioritize and support the administrative team, and tips on writing successful appeal letters. This episode is sponsored by Xtend Healthcare.
Summary
Preventing Denials in Healthcare: Tips from VP of Mid Revenue Cycle at Xtend Healthcare
Introduction
Denial prevention strategies are essential for healthcare providers to ensure maximum reimbursement for services rendered. In this episode, Colleen Goethals, the Vice President of Mid Revenue Cycle at Xtend Healthcare, shares her insights on how to prevent denials and offers tips on writing successful appeal letters.
The Current Denial Rate
According to Colleen Goethals, the current denial rate for hospital claims is 11%, a number that is increasing by 2% annually. To prevent denials, healthcare providers need to dig into data to identify trends by payer or provider, as well as coding issues. It is important to analyze the workflow, form a multidisciplinary team, and include departments such as patient access, utilization management, HIM coding, CDI, legal compliance, IT and physician liaison.
Administrative Support and Data
To prevent denials, health system executives need to provide administrative support and data. Prevention is key so having software and a prevention program in place is important. When appealing denials, the letter should be concise, include excerpts from the medical record, and include credentials of those writing the letter. Data is essential and collaboration with all appropriate parties is necessary.
Conclusion
Thank you Colleen Goethals for your time and insights on preventing denials in healthcare. Thanks to Xtend Healthcare for sponsoring this episode, and remember to check out Becker's Healthcare podcast page for more episodes.
Note: This is an AI generated transcript, not edited by a staff writer and is solely intended for educational purposes. If you have any questions/concerns, reach out to podcasts@beckershealthcare.com
This episode aired on 10/27/2022 and can be listened here.
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