Technological advances and imperatives for greater efficiency are driving the health care revenue cycle evolution. With the continual advancement of technology, providers need to look to restructure their process and tools to succeed. Clearly defining the procedure with a solution will help in leveraging what is happening across the health care continuum – in particular the areas where clinical care is provided and clinical activities seamlessly generate charges.

Denials prevention is currently the biggest challenge within clinically-driven revenue cycle management and can be prevented using a holistic revenue cycle approach with a denials management program. This presentation will review the components needed for a successful denials management program, including: charge capture, defending payor audits, denials prevention, denials committee/tasks force, and tracking and trending success.

Attendees will be empowered to:

  • Understand the fundamental differences between a back-end versus a clinically-driven revenue cycle denials management program;
  • Learn the steps needed to implement a successful denials management program in the changing revenue cycle paradigm; and
  • Discover what tools and resources are necessary to effectively appeal denials, manage payor audits, and reduce/prevent denials.

Speaker: John Hataway