RCM tip of the day: Use clinical merit to prioritize denied claims

Kelly Gooch - Print  | 

As hospitals aim for an efficient claim denials management process, they should prioritize appeals based on the clinical merit of individual cases, advises Tara Dwyer, vice president of audit operations at Xsolis.

"New technology and algorithms now provide insight into which cases are most likely to be overturned, giving denial management teams the starting point they need to engage with each case," she told Becker's Hospital Review. "By prioritizing, your team will be able to recover revenue sooner. Additionally, by looking at trends in this data, you can spot commonalities and opportunities for improvement throughout the revenue cycle."

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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