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    3 tips to take denials management processes to the next level

    By now, these medical payment denial statistics are old news:

    ·       50-65% of denied claims are never reworked

    ·       200 million claims are rejected every year

    ·       90% of denials are avoidable

    Although these numbers are common and, most likely, first-hand knowledge among providers, they continue to frustrate medical practices year after year.

    That’s why focusing on the last statistic—the 90% that are avoidable—is so important. That’s where the hidden revenue lies. Solving, or at the very least resolving, a good chunk of this issue, is one way to get denials under control.

    First, Physician Heal Thyself

    The first step is to remove the physician from the day-to-day denials-management process. Physicians around the world are already spending too much time behind a computer screen. A study published in the Annals of Internal Medicine found physicians spend a significant part of their day not treating patients, but instead completing other tasks. These physicians spent approximately 27 percent of their time in face-to-face clinical contact with patients, while spending up to four hours on “desk work” for every one hour treating patients. This study had a somewhat small sample size, but it’s easy to see that as contracting and billing grows more complex, physicians may end up spending even more time with a computer and less with patients.

     

    IN CASE YOU MISSED IT: The definitive guide to sustained patient engagement

     

    Whether the billing experts are members of the practice or external experts, physicians who hand off the denials management process increase the time they can spend with patients, and can improve productivity and boost revenue by allowing experts to take control of the process.

    Next: Bringing it all together

    Kevin Lathrop
    Kevin Lathrop is president of TriZetto Providers Solutions, which provides revenue cycle management systems to providers.

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