Managing medical necessity and notification denials.
Hospitals should take a strategic approach to denials management. Some key areas to monitor are: Prior authorization/notification. Concurrent review. The appeals process.
Olaniyan
Olakunle
O
Case Management Covenants LLC, Columbia, MD, USA. o.olaniyan@cmcovenants.com
Brown
Iskla L
IL
Williams
Kayode
K
D004469:Economics, Hospital / Q000458:organization & administration* / Q000639:trends; D006801:Humans; D007345:Insurance Claim Review / Q000191:economics*; D007349:Insurance, Health, Reimbursement / Q000191:economics / Q000639:trends; D008396:Maryland; D019564:Unnecessary Procedures / Q000191:economics*