Tag: payer denials

claim denial management

Claim Denial Management: A Comprehensive Guide

Claim denials are a common challenge for healthcare organizations, often leading to significant revenue loss. While it’s impossible to eliminate denials entirely, proactive Claim denial management can significantly reduce their impact. Industry standards for claim denials are lacking, making it difficult to track and analyze denial trends. Each payer has its own unique policies and […]
5 Ways to Reduce Claims Denial in Your Revenue Cycle

Reduce Claims Denial in Your Revenue Cycle

Claims Denial: Healthcare Leaders report an increase in payer denials, putting increasing pressure on the system’s finances. Going back and forth with denied payers is a long and expensive process, and low reimbursement rates don’t help either. In a new survey conducted by the Healthcare Financial Management Association, CFOs noted a significant increase in denials, […]

Medical Coding Strategies to Prevent Payer Denials

As a former emergency department physician from the U.K., this individual was well aware of claim denials and rejections, with payers frequently withholding or reducing payments. However, it was only when his personal insurance company, denied his medical claim for a vitamin D test that he decided to delve deeper into the issue. He found […]
denial-prevention-versus-denial-facilitation

Denial Prevention versus Denial Facilitation

  CDI programs tend to facilitate denials attributable to ingrained reactionary processes perpetuated by the query process. The COVID-19 public health emergency (PHE) has unleashed untoward burden and financial challenges associated with treating and managing acutely ill patients. Costs associated with such patients is overwhelmingly high, with often extended ICU stays in which the patient […]