Rethinking Denials Management

When it comes to managing medical claim denials, most provider organizations focus primarily on administrative causes. Maybe that’s why they’re not collecting as much as they should.
It turns out that most denial management programs have several flaws that, if corrected, can close the gap on the 90% of claim denials that are preventable.
This new paper from RelayHealth Financial explores a holistic, organization-wide approach to denials management that includes the intersection of financial and clinical factors. To understand how that approach can be implemented, the paper examines some of the most prevalent denial causes and then explores avenues for action to stem them.
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