Monday, December 13, 2010

what is denial management and plan or steps of denial management

Denial mangement is not a one-time event. It should be iterative and continuous.

Revenue collection at both the patient encounter and aggregate level should be established as key performance indicators for the entire organization, as opposed to individual departments only. After all, the modern health care cycle must be managed start to finish and include all administrative and clinical functions that lead to the presentation of claims for payment if revenue collection goals are to be met.

Plan, Do, Measure, and Adjust Steps of Denial Management

Aligning actual revenue collection with predicted revenue cannot be a one-time event. It needs to be an iterative and continuous process with the ultimate goal of guiding the provider's clinical and business course in the desired direction to support its mission.

It is safe to say that all providers are already involved in revenue prediction through the selection of revenue write-off percentages for specific accounting periods. But this is a clear case of passive management; it does little to explain variances and tends to "institutionalize" average historical write-off percentages.

Denial management technology introduces active management into the process of predicting revenue collection in several ways. Predicting revenues should be a continuous process, and this paper looks at effective steps to implement a focused denial management initiative.

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