Denial Prevention Management Program

At Affiliated Healthcare Management Group, we focus on a proactive measure to minimize and mitigate denials.

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

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We provide Hospitals & Health Systems with comprehensive revenue cycle management services