BC Advantage - 2009 Issue 12

Enhance Net Revenue by Improving Your Denial Management Program

Payer denials represent one of many revenue cycle challenges where prevention really is the best cure. There is always a cost associated with a claim denial. Whether it is the cost of researching the claim, filing an appeal, coordinating the provider response, or writing-off the claim, the provider experiences an increase in operating expenses, or a reduction in net revenue, or both with each denied claim.  In the aggregate, these costs can be substantial. HFMA and AAHAM have established a benchmark of d4.00% of gross revenue for denials. Our experience at IMA Consulting indicates that hospital...

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