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Winning at Denial Management with an Ounce of Prevention

11-2-2016-8-21-26-amGetting your car’s oil changed every 3,000 miles. Regularly brushing and flossing your teeth. Setting lights on timers before leaving for vacation. The common theme among these activities? As your mom or grandmother might have said, they show how an ounce of prevention is worth a pound of cure.

Like these precautionary measures, denial management requires a strong preventive component, and taking extra time up front helps cash flow and team productivity. Consider this powerful statistic: Even though only 66 percent of denials are recoverable, 90 percent are preventable*. Just imagine preventing 9 out of 10 of your practice’s denials!

In my recent webinar Gold-Medal Appeals, we explored several reasons healthcare organizations should improve denial management and appeals:

  • The ICD-10 Specificity Grace Period just ended on October 1
  • Payers continue to implement new claims management processing edits for both ICD-10 and VBR
  • Payment delays, audits and post-payment denials will likely increase as payers analyze the impact of new edits

Tweet: Learn how to use prevention and the 3 P’s to improve denials management>> http://ctt.ec/4n1S_+Tweet: Learn how to use prevention and the 3 P’s to improve denials management>> http://ctt.ec/4n1S_+

Health systems leaders recently discussed the importance of assembling a denial management team to prevent denials at the MGMA 2016 Health Systems Summit. They shared best practices as you’re building your prevention plan, including structuring efforts around the three P’s: people, process and product. For tips on using this structure to help build a taskforce, automate processes, establish the right workflow and analyze root causes of denials, view Navicure’s infographic, Teamwork Makes the Dream Work.

*Advisory Board, An ounce of prevention pays off: 90% of denials are preventable, December 2014