Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Denial Management

Real-Time Data for Denials Management Aids Practice’s Lagging A/R

August 18, 2017 - Without transparency throughout the claim denials management process, healthcare organizations are leaving a significant portion of potential revenue on the table. Limited access to timely claim denial and reimbursement data can prevent providers from recouping revenue that is rightfully theirs. As a result, providers are passing up an opportunity to recover reimbursement for up to 63 percent...


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Court to Reconsider Timeline for Medicare Appeals Backlog End

by Jacqueline Belliveau

The DC appeals court recently revoked the court-ordered elimination timeline for the current $6.6 billion Medicare appeals backlog, arguing that the previous court was in error of the law by requiring HHS to do away with the backlog despite the...

$262B of Total Hospital Charges in 2016 Initially Claim Denials

by Jacqueline Belliveau

Approximately 9 percent of hospital charges in 2016 were initially claim denials, according to a new Change Healthcare study. As a result, $262 billion out of $3 trillion in claims submitted last year was denied. The analysis of over 3.3 billion...

Top 4 Claims Denial Management Challenges Impacting Revenue

by Jacqueline Belliveau

For most healthcare organizations, claim denials are a normal, if not a frequent, occurrence. While very few can boast that their denial rates are close to zero, many providers face a number of challenges with implementing an effective claims...

Hospitals Still Facing Medicare Claims Denial Management Issues

by Jacqueline Belliveau

A recent American Hospital Association (AHA) survey indicated that hospitals are still experiencing challenges with Medicare claims denial management under the Recovery Audit Program. The survey of 676 hospitals revealed that about 60 percent...

5 Claims Denials Management Conversations From 2015

by Jacqueline DiChiara

This year, the healthcare industry lived in denial. Claims denial, that is. Claims denials management dialogues were extensive and recurring among healthcare providers across the industry this year.  Here are 5 claims denials management...

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