Denials Management Assessment

Our denials management assessment services are designed to assess the impact denials are having on an organization’s bottom line, as well as understand the drivers contributing to lost revenue for services rendered.

Our approach will identify the current state of denials management reporting, and denials prevention within the revenue cycle and provide recommendations to allow the organization to achieve performance excellence and minimize financial risk.

Denials Management Approach

We will review current state denial reports and payer remittance files to assess the impact denials are having on the aged accounts receivable, as well as, understand the drivers contributing to lost revenue. We will select a sample of accounts to identify root causes and process improvement initiatives to improve revenue capture and prevent denials. We will identify the following:

• Denial activity by payer and denial category
• Targets for revenue improvement
• Process improvement initiatives for denial prevention
• Potential appeals and revenue recovery targets
• Uncollectible accounts receivable