Denial Management

5/16/20241 min read

RCM denial management is a critical process aimed at reducing claim denials and ensuring timely reimbursement for services rendered. Denials occur when claims submitted to insurance are processed and left unpaid for various reasons such as incomplete information, coding errors, lack of medical necessity, or failure to meet payer-specific requirements. 

Effective denial management involves several keys steps: 

  • Identifying Denials 

  • Root Cause Analysis 

  • Provider Education 

  • Workflow Optimization 

  • Performance Monitoring 

By implementing a comprehensive denial management strategy, healthcare organizations can minimize revenue leakage, improve cash flow, and enhance overall financial performance.  

Do you need help determining the health of your revenue cycle?  Please contact us today to schedule a consultation. or 214-305-8805