Effective claims denial management enhances revenue.
Claims denial management can enhance revenue in times of declining payment and increasing cost pressures. Denials usually arise from process problems leading to inadequate documentation. A denial management team should oversee prospective prevention and claims recovery. Prospective prevention minimizes denials by defining scope of service, tracking causes for denials, and improving related processes. Claims recovery improves chances of recovering denied payment.
Hodges
Jackie
J
Med-Data Management, Inc., Mandeville, Louisiana, USA. jhodges@meddata-inc.com
D000368:Aged; D017598:Efficiency, Organizational; D001330:Electronic Data Processing; D005377:Financial Management, Hospital / Q000379:methods*; D006751:Hospital Information Systems; D006801:Humans; D007182:Income; D007344:Insurance Claim Reporting; D007345:Insurance Claim Review; D007349:Insurance, Health, Reimbursement; D008329:Managed Care Programs / Q000191:economics; D016344:Medicare Part A; D008922:Mississippi; D015397:Program Evaluation