Denials Mitigation and Process Improvement
With CBIZ, it’s not just about reducing denials; it’s about fixing problems and ensuring they stay fixed.
When involving CBIZ in denials mitigation, expect improvement. CBIZ isn’t content to merely fight your denials – whether they are inpatient, outpatient or physician; medical necessity or technical; government or commercial payers. For every type of denial, we have the same two goals: for hospitals to hold on to their entitled dollars and, most importantly, for there to be fewer denials.
According to national estimates, 9% of claims face some form of denial, and 3% of hospital revenue winds up being denied. Our goal is to reduce that number. What if your hospital or health system moves from 9% to 7%? How much money would that mean to your organization?
CBIZ combines 40 years of consultative expertise and the best data analytics in the industry to identify trends in your denials data. We work with you to triage which denials to pursue. We prepare clear and concise documentation for each denial we defend. Perhaps most importantly, we instill a process that helps reduce denials moving forward.
We understand that there are a variety of reasons for denials. It is our goal to identify the root causes of your denials, provide the proper education and ensure that denials are reduced. Are timely filing deadlines being missed? Is documentation presented clearly? What is the pre-authorization process in your organization? Are there certain physicians or case managers who more frequently see denied days from managed care?
The reasons for denials could be manifold; it’s our job to identify them and work with you to improve performance.