A New Method for Defeating Denials

65% is a substantial figure. Think about it: if your favorite store sent you an email, “65% off all sale items,” you’d be happy. If your kid’s college raised tuition by 65%, you wouldn’t.

That’s why the statistic, “65% of denials are never reworked*,” is so critical. Most of the time, practices aren’t sure why all of their denials happened—therefore, they can’t be sure they won’t make the same errors again. Today’s revenue cycle is becoming more complex every day due to the many new value-based reimbursement plans. This complicated billing environment coupled with a lack of information regarding claims errors can create a cycle of lost revenue.

Fortunately, you can employ an analytics solution to help you identify errors in your claims billing process. If integrated with your clearinghouse, an analytics solution can help you defeat denials in two ways:

  • Help you identify denials before they happen (for instance, at the eligibility verification stage)
  • Enable you to monitor data so you can identify trends (for instance, errors at a specific point in the process or by a team member)

Once you catch these denials, you can stop them from becoming downstream problems such as bottlenecks, sluggish cash flow and lost revenue. And as an added bonus, as you continue leveraging analytics, you can always keep an eye on processes—so you can ensure your team is continuing to improve and gain more claims revenue.

Interested in learning more, such as specific examples of how analytics can help physician practices defeat denials and the best criteria for selecting an analytics solution? Download our eBook, Defeat Denials with Data.

*Haines, Morgan, An Ounce of Prevention Pays Off, The Advisory Board, December 2014

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