Improving Outcomes in Revenue Cycle Management. Module G. Denial
Coverage denials are a huge threat to a hospital’s revenue cycle. This module details how an organization can create a process to mitigate that threat as much as possible—by managing denials but also by preventing them. It begins by detailing the main causes for denials, and the common denial policies among large healthcare payers, such as Medicare. Next, it explores strategies that the transdisciplinary team can use to prevent denials, such as proper pre-authorizations and coding.