Manage Denials

With payers denying 12 percent of claims on average, it’s no wonder 75 percent of revenue cycle leaders say reviewing denials and submitting appeals is the most time-consuming part of their jobs. 

Despite the challenges, most healthcare organizations are still not automating any part of their denials processes. 

When RevFind reveals the sources and types of denials your organization receives, you can address root causes and change workflows to prevent them. With RevFind, denials backlogs shrink, workloads ease, and your organization maximizes reimbursement.

Get clarity on your denials once and for all

If you’re like most revenue cycle professionals, year after year you commit to reducing denials. Denials persist, however, because keeping up with their constant inflow doesn’t stem the problem at its source. Instead, curbing denials requires data-driven analysis of where the most persistent and costly denials come from. 

The most common root causes of denials are: 

• insufficient prior authorizations

• inaccurate or insufficient documentation

• insurance coverage issues

• coding errors

• lack of medical necessity

• timely filing limit exceeded

Each of these issues can be tackled with proactive strategies – once they’re discovered, that is. 

RevFind generates clear reports that help your team understand the codes and payers triggering costly denials. Root cause identification and trend analysis allow you to prevent denials before they occur.

Escape rigid EHR denials systems

Your EHR may have a denials reporting feature. Often, however, such EHR-level features aren’t that useful because they provide limited data points and restrict access to specific team members.

RevFind has been engineered to be flexible to your team’s needs. Powered by claim and remittance transactional data from your PM system or clearinghouse, RevFind's reporting interface allows for the analysis of denials at the claim line level. Denials can be analyzed and reported by an array of dimensions, including denial code, procedure code, facility, provider, insurer, and more. Rather than be forced into standard reports, any user can pull custom reports on the information they need.

By getting more of your staff the information they need to address denials and submit appeals, RevFind empowers your team to maximize cash flow.

Automate denial assignments for rework

Without clearly defined workflows and assignment of responsibilities, denial appeals can slip through the cracks.

RevFind's workqueue feature automatically assigns denials to the appropriate team members. Assignments can be automated by denial type, insurance, provider, facility, or many other criteria. Team members can designate which denied claims are ready for appeal and generate reports to submit to the payer for reprocessing. The result is less confusion and a more proactive appeals process.