Decrease Costs and Increase Revenue by Proactively Avoiding Denials

Getting paid for clinical services should be a straightforward process. You capture the patient’s insurance, verify eligibility and obtain the needed pre-cert or prior authorization. Then you see the patient, document the visit, code the service, send the claim, and get paid. This should be all.

But if that were the case, you would not need a billing department. But with 90% of the denials being preventable, you can have a very lean team by proactively avoiding denials.

Ignoring the causes of your denials and simply appealing your claims can have a significant financial impact on your organization.

Prioritize process improvement initiatives by determining which can be addressed quickly and easily and those which will give you more bang for your buck. Do not try to solve all problems at once. Quick wins will motive your staff and encourage their participation and buy-in.