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10 Dynamic Strategies to Powerfully Prevent Healthcare Claim Denials
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Welcome to episode nine of the RevTech Rx Podcast- Your Prescription for a healthy revenue cycle! Streamline Health, a leader in pre-billing coding optimization, powers this episode.
Learning how to prevent medical billing denials is crucial for healthcare providers as claim denials continue to rise and inflate billing- and insurance-related costs (BIR). Our panel of experts discusses their five tips for denial prevention, which include simply communicating and verifying insurance prior to authorization. We also dig into more complicated tips such as setting up a line of communication between patient financial service teams and the clinical team for case management.
With these tips, revenue cycle professionals can gut-check their existing processes and perhaps learn new opportunities to reduce denials.
Connect with our panel of experts:
David Kosloski- Host
https://www.linkedin.com/in/david-kosloski/
Ian Sullivan- Senior Director at HealthRise Solutions
https://www.linkedin.com/in/iansullivan1/
Jodi Stewart- Senior Vice President of Services at Streamline Health
https://www.linkedin.com/in/jodi-stewart-8244a316/
Chapters
00:00 Introduction
00:43 Tip # 1 From Jodi: Using Pre-bill Auditing Technology
1:34 Tip # 1 From Ian: Understanding Payer Contracts
3:13 Tip # 2 From Jodi: Have an Updated Chargemaster
3:36 Tip # 2 From Ian: Establish a Revenue Integrity Team
5:40 Tip # 3 From Jodi: Expanding on the Revenue Integrity Team
6:45 Tip # 3 From Ian: Implementing a Pre-service Team
9:59 Tip # 4 From Jodi: Managing Out-Patient Claims
10:40 Tip # 4 From Ian: Optimize your H.I.S.
12:01 Tip # 5 From Jodi: Establish Key Performance Indicators
13:05 Tip # 5 From Ian: Build a Partnership Between Case Managers and the Revenue Cycle Team
14:03 How to Prevent EMR Gaps
15:48 The Importance of a Revenue Integrity Team
18:08 The Valley Between Case Managers and the Revenue Integrity Team?
20:00 Jodi's Summary of Her 5 Tips for Preventing Denials
20:20 Ian's Summary of His 5 Tips for Preventing Denials
21:00 Conclusion
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