Proven Denial Management Strategies to Boost Your Revenue Cycle
Claim denials are one of the persistent challenges that healthcare providers face in the RCM process. Denial leads to delayed payments, which in turn result in increased administrative costs and decreased staff productivity. Efficient denial management demands both proactive prevention and reactive solutions. Here are the most effective denial management solutions that can help healthcare […]
Top Denial Management Metrics to Track for Faster Reimbursement
Strategic denial management is important to ensure financial stability in a healthcare facility. It helps to enhance operational efficiency by reducing administrative burden on healthcare staff and allowing providers to focus on delivering exceptional care. In today’s complex U.S. RCM process, claim denials are the biggest drains on providers’ margins, cash flow, and overall productivity. […]
Step-by-Step Guide to Appealing a CARC 213 Denial
Medical billing can be a headache, and the notorious CARC 213 code often adds to the frustration. This denial code appears when a provider bills for a service that the payer explicitly excludes in the contract. In simpler terms, the insurer decides the procedure doesn’t qualify for payment under the patient’s plan. If you encounter […]
How Denial Management Differs in Hospital vs. Outpatient Settings
Denial management is a critical aspect of revenue cycle management (RCM) that ensures healthcare providers receive timely payments for services rendered. Whether in a hospital or outpatient setting, an effective denial management strategy can significantly impact financial stability. However, the complexities of managing claim denials vary between these settings due to differences in billing systems, […]