BC Advantage - 2024 Issue 9

Navigating the Storm: Key Strategies for Effective Denials Management in Healthcare

In the intricate landscape of healthcare financing, denials management emerges as a formidable hurdle, especially amidst the surge in clinical and technical denials. These denials not only lead to payment delays but also set off a chain reaction of adverse financial ramifications, including increased labor or vendor expenses for appeal processes and heightened write-offs. Consequently, healthcare leaders find themselves compelled to embrace proactive measures to navigate these challenges and uphold financial stability.   Medical billing denials generally fit into two main types: hard denials and soft denials. Hard denials occur when claims are outright rejected, necessitating corrective measures for...

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