The Importance of Denials Prevention

Denials management is one of those evergreen topics that is always on the mind of a revenue cycle practitioner – coming up with new ways to solve, implementing the newest tools, the fanciest follow-up methodologies, etc. The reality is that once you have an effective system in place for working denials, the next step is to focus on preventing them from occurring. While you will never be able to prevent 100% of denials, you can definitely reduce their frequency by focusing on “low hanging fruit.” According to often-cited industry metrics, approximately 90% of denials are preventable or avoidable.

Before you can implement a denials prevention program, you need a few key things in place:

  • Good reporting on your denials – both current and historical
  • Buy-in from all levels of staff – from front-end to senior leadership
  • A solid program in place to work denials

With these components in place, the process for setting up an effective denials prevention program can proceed. The Wilshire Group can work with you to help tailor a program to fit your organization’s needs.

Key benefits to denials prevention:

  • Reduced “touches” on an account
  • Decreased time in AR
  • Decreased cost to process a claim

Whether you’ve tried implementing a denials prevention program previously or this is your first time – we can help. At The Wilshire Group our team of experienced consultants can review your denials management program, and determine how a prevention program would benefit your organization.

Contact Martin Barker today for more information!

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