You may not be aware of it, but your hospital may already be losing money because their revenue cycle is not optimized. How you may ask, when you’ve made sure that everything about billing has been accurate so far? Have you thought about denial management? If your hospital has not fully evaluated its coding processes and optimized them, then you may not be getting the proper amount of reimbursement for the amount and level of care you are providing.
It’s important for healthcare providers to conduct regular assessments of coding practices and never fail to look for areas of improvement. Ask yourself—does your staff have full knowledge regarding codes that can and cannot be accepted in relation to the care that the facility provides? Are coding errors being addressed immediately and efficiently? Do you provide regular staff training to make sure these errors are minimized, if not prevented?
Denials are among the most common reasons for a hospital’s financial burden. As such, facilities should make it a point to carefully examine their denial rate and identify the most common reasons for them. In addition, administrative errors should be assessed, and a well-thought out process for appealing denials should by implemented by management to recoup lost money.