decisionhealth Newsletters, Part B News - 2000 Issue 11 (November)
Tracking denials saves money, frees up resources
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Article Overview
This article discusses practice billing workflow strategies for tracking claim denials and rejections, with emphasis on payer-focused staffing, accounts receivable monitoring, and using carrier reports to spot recurring problems. It is aimed at revenue cycle staff, billers, coders, and practice managers who want a general overview of denial trend tracking and billing error reduction. The piece also references coding-related issues and carrier adjustment patterns that affect claim processing.
Why This Topic Matters
Understanding denial patterns can help practices identify recurring billing problems, reduce avoidable delays, and better organize follow-up work across payers. The article is relevant to teams responsible for accounts receivable performance, coding accuracy, and claim resolution workflows.
Article Sections
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The pod approach
Describes a payer-focused billing workflow and the general idea of assigning staff responsibility by insurer. It also covers related practice management incentives and accounts receivable organization.
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Bucket system for aging claims
Explains a claim-aging framework used to group outstanding accounts by time outstanding and monitor cash flow. The section discusses how older claims are monitored within the practice's internal process.
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Carrier profile
Covers monthly carrier reports used to review billing errors, claim denials, and adjusted claims. It also introduces broader techniques for spotting patterns when carrier reporting is limited.
What You Will Learn
- How payer-specific billing teams can be organized to follow claims through the process
- How claim-aging categories can be used to monitor outstanding receivables
- How monthly carrier reports can support denial trend analysis
- How internal tracking can help identify recurring rejection patterns
- How denial monitoring supports ongoing revenue cycle improvement
Who Should Read This
- Medical billers
- Medical coders
- Revenue cycle staff
- Accounts receivable managers
- Practice administrators
- Physician office managers
- Billing consultants
Codes Discussed
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