Word on the Street Denials: Provider Perspectives

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Amanda De Los Reyes - Valleywise Health

We're doing a lot with analytics, scoring our denials, which a lot of organizations do, to try to understand where some of our bigger opportunities are. And we're also going to be using the BDC records within Epic to help root cause some of those. Every time you are able to prevent one type of denial, something else pops up.

You know, denials

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Brandon Burnett - Community Medical Center

in healthcare have been on the rise, especially coming out of COVID. As you can imagine, the administrative cost and rework is astronomical. What technology do you have to use? Because you can't do it without technology.

So our denials

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Candice Powers - University of South Alabama

management strategy has really morphed over the last twenty-four months. We have reengaged our denials management action team where we attribute denials. Then we really dig into those areas. What we've actually seen is a decline in our shop, which I know is unusual, but it's a true testament to the engagement and the accountability that they're instilling in their folks. Denials

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Terri Meier - University of Arkansas

are really high on our priority list.

I spend a lot of time in our middle revenue cycle, monthly meetings with our service lines to go over their denials and really review the ones that are preventable to try to work to some sort of denial mitigation plan.

What we're trying to do is figure out why it happened and then what we can do to prevent it from happening again in the future.

In claim denial is the number

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Rudy Braccili - Keck Medicine of USC

one issue on my radar. We use automation wherever we can, mostly for the low-dollar, high-volume denial types. And we use critical thinking to find out what the real root causes are and take it from there. For example, downgraded DRGs, right? There's so much to it. So that's one area that we're really focusing on.

The ability

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Jason Metcalf - CommonSpirit Health

for payers to automate denials or to reject information right away has become probably pretty lucrative for them. For us, to be able to respond quickly and timely to the different issues is critically important. As technologies increase, the volumes increase significantly.

We prioritize

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Vanessa Couch-Laguana - Valleywise Health

our top three denials in both volume and dollars to ensure that we are getting the root cause of where the denial is starting, ways, and opportunities for denial prevention.

Discover how to tackle denials head-on. Visit: finthrive.com/stop-denials