You don't need to be told that the longer you sit on a denial, the more money you lose. What you do need is a strategy for dealing with denials more quickly, effectively, and efficiently. To develop that strategy, you need to understand how and why denials happen. You need to find the weaknesses in your system, fine-tune processes—or overhaul them if necessary—and make sure every member of your staff understands and plays their important role in your organization's financial success.
a wealth of easy-to-use denial tools you can customize for your organization, including denial definition checklist, remittance advice self-audit spreadsheet, and contract language suggestions For every member of your revenue cycle team . . .
The book and CD-ROM are an invaluable combination, not just for the finance team charged with maintaining the bottom line, but for the executive team and other members of the revenue cycle team. Everyone will learn and understand what they need to do to erase bad habits, reassess the organization's progress, and develop a process that addresses the ongoing denial management challenge.
Denial Management: Key Tools and Strategies for Prevention and Recovery is a must-read for provider-based managers of the revenue cycle, including the finance staff, PFS directors, and managed care directors. Members of the executive suite, patient access, HIM, case management and utilization review, and compliance and audit departments will learn valuable strategies to help their teams make stronger contributions to the organization's revenue cycle.
Take a look at the Table of Contents
Chapter 1: Why worry about denials?
Chapter 2: Measuring your denials
Chapter 3: Focusing operational efforts to reduce denials
Chapter 4: Clinical denial management: Where finance and medicine collide
Chapter 5: Using technology in managing denials
Chapter 6: Managing the revenue recovery process
Chapter 7: Legal avenues for recovery
Chapter 8: Case studies
Chapter 9: Conclusion
Chapter 10: Tools
Meet the Author
Pam Waymack, MBA, CHFP, CPHIT, is managing director of Phoenix Services Managed Care Consulting, Ltd. in Evanston, IL, a firm that specializes in improving financial performance in healthcare. She has 25 years of experience in managing and turning around the financial performance of healthcare organizations across the country.
Meet the Editorial Team
Rose T. Dunn, FHFMA, RHIA, CPA, CHPS, FACHE, is chief operating officer of First Class Solutions, Inc. of St. Louis, Mo. She is a member of the editorial board of PFS Advisor and Medical Records Briefing, and author of More with Less, all from HCPro.
Barbara Aubry, RN, CCM, CPC, CHCQM, is a healthcare policy specialist for 3M HIS in Rockleigh, NJ. She is a contributor to HCPro's PFS Advisor, PFS Weekly Advisor, and to Compliance Monitor's "Ask the Expert" column.
Dr. Joseph Zebrowitz is executive vice president of Executive Health Resources (EHR) of Newtown Square, PA. In this role, he has developed EHR's suite of clinical revenue cycle management services—endorsed by the AHA as "Best in Class."
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