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)

Outcomes:

• 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