Ask the Experts: Medicare Adjustments During Appeals
Can we adjust a denied Medicare charge off of an account when an appeal is still open?
Ask the Experts: Denial Write-Offs
What is the best practice target for denial write-offs as a percent of net revenue?
3 Key Disciplines for Productive Denials Management
Tracking trends, categorizing denials by code, and implementing root cause analysis processes are actions that provide steady progress toward denial management.
Appealing Medicare Denials in an Age of Reform
New reforms are giving providers more options for appealing Medicare claims denials, yet early preparation of appeals is essential.
It All Starts with Patient Access
Because patients now face higher out-of-pocket costs, patient access staff play a greater role than ever. These staff members need to be more than information gatherers. They need to be patient advocates, gifted with genuine empathy and know-how—not only to guide patients through the financial experience, but also to set the stage for clean claims downstream.
Increase Cash Flow by Giving Your Business Staff Meaningful Work
The pillars of strong revenue cycle operations are creating meaningful work, developing knowledge, removing obstacles, and advancing analytical capabilities. Revenue cycle leaders can achieve these goals by integrating payer and claims data and applying algorithms to optimize staff efforts.
ICD-10 Denials and Payment: Understanding the Relationship
Proactive, established processes to prevent denials and better manage appeals minimizes citation risks while promoting optimal, timely payment and compliance.
HFMA/Change Healthcare: Pre-Authorization and Medical Necessity Opportunities
Change Healthcare and HFMA partnered on a research study that analyzed the state of claims denials in the United States. It focused on understanding providers' first-pass claim rates, denials occurring from lack of pre-authorization and medical necessity processes, and pain points that are opportunities for innovation.
Process Improvement Can Prevent Denials
Approximately two-thirds of the top ten reasons for denials during the first quarter of 2017 were related to patient access issues.
Ask the Experts: Managing Denials
I am considering creating a denials team and managing all the denials in patient financial services. How have you managed denials and achieved success?