RCM tip of the day: Identify denials early

As hospitals strive to improve revenue cycle management performance, lowering claim denial rates remains a key focus.

One way to achieve success in this area is to develop a clear understanding of types of denials, such as technical issues and medical necessity, and categorize them so they are easy to understand, according to Brandon Rife, president of Kemberton, which provides specialized revenue cycle management and revenue recovery services. This ensures accounts are routed appropriately and reduces days in accounts receivable due to lengthy appeals processes.

"If a hospital lets an account age in their receivables, they can quickly let six months lapse and any rights to appeal the denial can go by the wayside," says Mr. Rife. "So timely and early identification is important, whether that's dedicating a team to it or spending money on software to help them identify and then categorize the types of denials the hospital is seeing."

Read more tips from Mr. Rife here.

If you would like to share your RCM best practices, please email Kelly Gooch at kgooch@beckershealthcare.com to be featured in the "RCM tip of the day" series. 

 

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