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Revenue Cycle

Enhancing Denial Prevention and Management Across Functional Areas

Given the rise in denials (caused by an evolving regulatory landscape and shifting payer requirements), hospital and health system leaders across the country are undoubtedly finding themselves embroiled in conversations regarding not only how to manage incoming denials, but to also prevent their occurrence. This can prove daunting, as even the slightest of errors at any point in the revenue cycle have the potential to limit or forestall payer reimbursement. As such, success in preventing denials may ultimately be linked to an organization’s ability to implement multiple measures within the front, middle, and back end of the revenue cycle.

To gain insight into one organization’s multifaceted denials approach, The Academy’s May virtual conference explored the numerous efforts a three-hospital health system in Florida has leveraged to prevent avoidable denials and appeal wrongful denials. Throughout the conference, the assistant vice president of revenue cycle shared numerous strategies organizations may be able to deploy within each of the revenue cycle’s key areas.

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