The denial resolve rate “can be determined by dividing the total number of claims paid for a given time by the total number of claims in that same period,” she said. “The higher the percentage, the better.”
“A high percentage rate means your staff is working effectively. If your rate is low, analyze your eligibility, coding, authorizations and credentialing processes. What can be automated to streamline your staff’s workflow? Remember that on average providers spend $118 per claim on appeals, so simplifying your processes will improve both cash flow and staff productivity,” said Ms. Tropea.
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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