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Differentiating The Exceptional From The Conventional: Using ECM To Improve Claims Denials Management
By James Thumma, VP of Sales and Marketing, Optical Image Technology
A solid ECM system can further enhance your denial processing strategy by allowing you to track, monitor and measure the causes of your claims denials. Reporting capabilities that are available with certain ECM systems can provide—in graphic representation—a summary of the reasons your claims are being denied. Comparing your denials enables you make proactive decisions as you target specific areas for improvement. For example, if you discover that the majority of your denials are a result of incomplete (or incorrect) demographic information, you can configure your workflow system to ensure that patient demographics are complete and up-to-date before claims are submitted.
Using that same scenario, it is equally important to have an overview of which denials are causing you to lose the most revenue. Some business areas may account for a smaller number of denials, but if the amount of revenue involved is significant, it may be wise to make that area a higher priority. By choosing an ECM system that can integrate with your A/R software, you can compare the financial losses from denials that are associated with different areas of your enterprise. Having this information available leads to better decision-making and more informed management.
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