RCM tip of the day: Use an automated solution to tackle claim denials


As healthcare organizations continue to struggle with claim denials, an automated solution can help limit the issue, according to Kevin Lathrop, president of TriZetto Provider Solutions, a Cognizant company.

Mr. Lathrop shared the following tip with Becker's Hospital Review.

"One way to keep denials from happening in the future is by stepping away from the manual processing that takes place at a computer terminal, and replacing it with an automated claims and denials system. An automated system has the benefit of knowing payer codes. Treatment codes change over time and must be kept up-to-date. Keeping track of them by hand is difficult and time-consuming, but an automated solution has the ability to keep codes updated by automatically requesting and receiving payer updates.

"Office staff can use the automated system to understand why the denials occurred and make workflow changes to lessen the chance they'll happen again moving forward."

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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