Our approach is to understand the root cause, analyze, track, and trend each denial reason; so preventative measures can be taken within the payer’s timeframe, and opportunities to prevent denials in the future by establishing effective workflows, and on-going education.
Denial prevention is an on-going effort that requires collaboration among different service areas within your organization. Implementing a solid multi-disciplinary approach can significantly improve your revenue cycle management. Affiliated HealthCare Management group is a trusted partner that is ready to develop a tailored-made program.
Affiliated Healthcare Management Group can perform the following:
- Review 835’s and identify root causes of denials.
- Provide clear understanding of denials by payer, reason, remarks, department/service, and user generating the denials.
- Work with Revenue Cycle staff to remediate existing cause of denials.
- Work with payers to resolve inappropriate denials on a look back and go-forward basis.
- Consolidate follow-up activities to improve outcomes and minimize costs.
- Assist Revenue Cycle team with understanding the root-causes and assist in developing strategies and procedures that minimize future denials.
- Provide monthly reports identifying trends and cash-flow projections based on denial work queues.
- Maintain regular communications with interested department stakeholders to improve success.
- EPIC- Denials related dashboards and analytics tools such as slicer-dicer review
- EPIC Denial Query reporting review and guidance
- EPIC-remit code and build review (assistance)
- Effective use of data analytics and strong reporting system
- Improve net revenue collection and overall financial performance
- Improve clean claim rate
- Increase Patient satisfaction
- Improve AR days and Aging Receivable
- Improve visibility on critical issues affecting Organization
- Improve Resource Efficiency
- Lower Expense