Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Best practices for preempting payment denials.

Dennis J Scotti1, Lewis D Bivona, Sheri Modell

  • 1Fairleigh Dickinson University, Teaneck, N.J., USA. prof_djs@fdu.edu

Healthcare Financial Management : Journal of the Healthcare Financial Management Association
|May 9, 2003
PubMed
Summary

Reducing inpatient claims denials involves using accurate payer data systems, proactive denial prevention strategies, adhering to payer protocols, and improving front-end staffing. These elements are crucial for financial health in healthcare.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

A real-world comparison of the clinical and economic utility of OVA1 and CA125 in assessing ovarian tumor malignancy risk.

Journal of comparative effectiveness research·2023
Same author

A 90-Day Episode-of-Care Analysis Including Computed Tomography Scans of Robotic-Arm Assisted versus Manual Total Knee Arthroplasty.

The journal of knee surgery·2022
Same author

Use of combinatorial pharmacogenomic guidance in treating psychiatric disorders.

Personalized medicine·2018
Same author

Economic Impact of Increased Utilization of Multivariate Assay Testing to Guide the Treatment of Ovarian Cancer: Implications for Payers.

American health & drug benefits·2017
Same author

Systematic review and meta-analysis of controlled and prospective cohort efficacy studies of endoscopic radiofrequency for treatment of gastroesophageal reflux disease.

Surgical endoscopy·2017
Same author

Budget Impact Analysis to Estimate the Cost Dynamics of Treating Refractory Gastroesophageal Reflux Disease With Radiofrequency Energy: a Payer Perspective.

Managed care (Langhorne, Pa.)·2016

Area of Science:

  • Healthcare Administration
  • Revenue Cycle Management
  • Health Information Systems

Background:

  • Inpatient claims denials pose a significant financial challenge to healthcare providers.
  • Effective denial management is essential for optimizing revenue and operational efficiency.
  • Existing strategies often fall short due to fragmented approaches.

Purpose of the Study:

  • To identify key components necessary for effectively limiting inpatient claims denials.
  • To provide actionable insights for healthcare organizations seeking to improve their denial management processes.

Main Methods:

  • Analysis of critical factors in denial prevention, including data management, process optimization, and staffing.
  • Review of best practices in payer data collection and protocol compliance.

Related Experiment Videos

  • Evaluation of the role of front-end processes and staffing in claim submission accuracy.

    • Main Results:

    • Successful denial limitation requires integrated systems for accurate payer data collection.
    • Proactive, creative processes are vital for preventing denials in high-risk areas.
    • Strict compliance with payer protocols and enhanced front-end staffing are indispensable.

    Conclusions:

    • A multi-faceted approach combining technology, process innovation, and human capital is essential for minimizing inpatient claims denials.
    • Investing in robust data systems, staff training, and streamlined workflows directly impacts financial performance.