Ask a Revenue Cycle Leader is a new series featuring insights from health system and hospital revenue cycle executives nationwide. Becker’s poses questions on the most pressing issues in healthcare finance — from payer relations and automation to workforce and patient experience.
This week, Becker’s asked leaders how they are reducing payer denials.
Question: What is the most effective strategy you’ve implemented in the last year to reduce denials?
Editor’s note: Responses were lightly edited for clarity and length.
Paul LePage. Vice President of Revenue Cycle at UC Davis Health (Sacramento, Calif.): The most effective strategy we implemented this year was a comprehensive denial mapping initiative that focused on identifying true root causes and eliminating non–value added work. We built a denial taxonomy that tied payer codes to operational ownership and stratified denials by preventability, financial impact, and overturn probability.
By stopping low-yield appeals and redirecting resources toward upstream prevention — such as authorization accuracy, eligibility verification, and documentation improvement — we reduced rework and improved clean claim performance. This worked because we treated denials as process defects to eliminate rather than inventory to manage, creating shared accountability across the revenue cycle and clinical operations.
Cindy Otero. Senior Director of Revenue Cycle at NCH Medical Group (Naples, Fla.): Meeting with each specialty/practice leader on a monthly basis to review and decrease denials by category. Holding the front-end responsible truly helps.
Next question: What is one issue in revenue cycle that you think is underappreciated or not discussed enough?
If you are interested in responding, please send responses to Andrew Cass at acass@beckershealthcare.com.
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