Denial Coding Guidelines
- SolvEdge
- July 15, 2021
- 4 mins read
Claim denials are amongst the topmost sources of revenue loss that have a direct impact on the cash flow of healthcare organizations. Denied claims alone have costed Hospitals across the U.S, a staggering $262 billion a year—leading to major financial losses and increased recovery costs. Consider that an average claim denial rate is at 9%—leaving about $5 million of money on the table.
Though there are multiple factors causing claim denials, coding errors are amongst the primary reasons for denials. However, the good news is that 90% of denials are preventable. With a strategic approach and a streamlined denial management process, Hospitals and medical practices can manage as well as prevent future denials.
Denied claims alone have costed Hospitals across the U.S, a staggering $262 billion a year—leading to major financial losses and increased recovery costs.
5 Strategic Ways to Manage Coding Denials
The denial management services involve complex workflows that require a focused strategy and a nuanced approach to achieve sustainable results
1. Educate. Providers about digital documentation that supports medical coding and collaboration
2. Credential. Ensure that the medical coders are certified and updating their certifications through continuous learning
3. Create. Specialized workflows for denial resolution. This will also provide actionable insights on denial prevention
4. Confirm. Use technology, such as advanced scrubbers, to confirm payer coding rules are followed
5. Increase. Efficiency and mitigate human error by using a single platform for codingrelated activities
Learn more about how SolvEdge’s denial management services can accelerate your revenue cycle performance.
Contact us – 48 hours is all it takes to get your No Cost Root Cause Analysis to prevent denials from the ground up!
