REDUCE CLAIMS DENIALS

Increase Profits by Decreasing Denial Triggers and Appealing Denials More Effectively

Denied medical claims drain critical financial resources away from patient care. Most health systems in the United States lose significant net revenues as a result of payment denials from insurance companies. With a formal denial management program that includes a rigorous training curriculum, your facility can reduce the potential for loss. The Avoiding Claims Denials library from the Healthcare Financial Management Association was designed specifically to provide revenue cycle staff with the tactics necessary to improve denial management. With this library, your staff will learn how to decrease denials by correctly securing more of the critical required information in advance, prioritizing the workflow, identifying contract terms that should be renegotiated, and appealing denials more effectively. With better denial management processes in place, your bottom line will improve along with both patient and employee satisfaction.

Impact:

Submit More Clean Claims

• Collect more accurate coordination of benefits data
  
• Obtain and document precertification
  
• Screen for medical necessity and eligibility efficiently
  
  

Improve Profitability

• Spend less time and resources researching and correcting denied claims
  
• Create more efficient and effective work flow processes
  
  

Increase Patient Satisfaction

• Help patients understand insurance concepts such as precertification
  

Features:

• Comprehensive library of seven courses, totaling over 20 hours of material
  
• Suitable for both new-hire and refresher training for experienced staff
  
• Industry, peer-reviewed education from the industry leader
  
• Complemented by HFMA’s Billing Suite and other content libraries

This library is essential for:

• New-hire orientation programs
  
• Process improvement initiatives

This library supports:

• Professional development programs
  
• Employee retention improvement initiatives

Library Outline:

This comprehensive library includes the following seven courses with 80 distinct lessons:

• Scheduling
  
• Pre-Registration
  
• Registration
  
• Validation of Demographic and Insurance Information
  
• Insurance Verification
  
• Pre-Certification and Notification
  
• Claims Denial Management
  

Subject Matter Experts
The Avoiding Claims Denials Suite was developed by the experts at the Healthcare Financial Management Association.

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