BC Advantage - 2024 Issue 8

Enterprise-Based Denial Management: A Comprehensive Approach

With denied claims rising – up 10.15% in 2020, 11.2% in 2022, and then 11.99% in 2023 (according to Fierce Healthcare) – it is clear that healthcare organizations face an escalating challenge that demands a comprehensive, thorough strategy.   Tackling this pervasive problem requires more than just reactive, payor-specific denials management tactics. Instead, adopting a holistic, enterprise-wide approach can lead to substantial improvements in managing denials.   Holistic vs. Fragmented Denials Management Strategies   A holistic, enterprise-wide denials management strategy is comprehensive and proactive – it integrates all aspects of the revenue cycle with centralized data...

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