
Speakers
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Craig Mills
TruBridge
Sessions by Craig Mills
1.25 CEU
Grapevine A
Mon, May 4 at 10:45 AM CDT (03:45 PM UTC)
75 MIN
2E | Transitioning Denials Management into Denials Avoidance: A Proactive Approach to Compliance Success
Hospitals and health systems have long relied on appeals to address ongoing costly payer denials due to medical necessity, clinical validation, DRG downgrades, and level of care downgrades. This process is time-consuming, labor-intensive, and expensive, with no guaranteed success in the form of an appeal overturn. Taking a proactive approach is more effective as a denial avoidance strategy. Automation can also be applied in areas of clinical denial appeal generation, payment management, and coding to support the adoption of revenue cycle processes and meaningful, actionable feedback loops. This session explores a multi-modal approach to addressing chronic payer behaviors in the pre-bill, first-pass claims submission, targeting a reduction in overall denials and complete patient care-focused claim submission.
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Outpatient Facility