Thursday, July 8, 2010

Three key fundamentals to effective denial management

The three key fundamentals to effective denial management.


Prevention focuses on actions that can be taken upstream in the patient encounter to prevent denials from occurring in the first place. Prevention can be introduced anywhere in the patient encounter such as: Pre-admit/Pre-registration, Scheduling, Admit/Registration and Billing. Our denial management experts ensure that we track such trends and keep the Client informed periodically about improvements/process changes that can be made across functions.


The process of analyzing and aggregating similar denials is strategic in denial management. The Denial management team understands that analysis and segregation is a forerunner to follow-up process and hence for us it is an fundamental step in denial management.

Tracking and Trend Management

Besides keeping a track of the denial trend from payers our experts also actively monitor the payment patterns from various payers and set-up a mechanism to alert when a deviation from the normal trend is seen. This is important in understanding the causes of claim denials and enhancing long-term efficiency and drastically reducing lost revenue.

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