Denial prevention committees

jwmccurleyjwmccurley
in DENIALS & APPEALS
I'm curious what other systems are doing in terms of having a denial committee that regularly reviews and tries to prevent denials. If anyone is interested in discussing this topic let me know and we can connect. Thanks! 

Comments

  • carrilkicarrilki
    Our PFS department has been solely responsible for denials at my facility. But, my new CFO has asked me to reach out to my PFS director and ask if Revenue Integrity could help with denials. We strictly have our hands on Outpatient services, mainly Emergency Services and I was hoping to reach out and see if anyone had any suggestions on where I should look and how I could get involved with making an impact in the denials world.
  • stoutbstoutb

    For years PFS has been responsible for denials.   We are changing our model and pushing that upstream and the C suite is holding the clinic leadership responsible for reporting on their denials outcome.  The end game is a downward trend as leadership sees their accountability.   The analyst pushes the monthly denials out to the departments and we also have monthly meetings to discuss with all involved.

    PFS still manages turning them around but the ownership is now expanding

  • stmsmithstmsmith

    My position as Revenue Integrity Director was just created a few months.  When my position was created they also created a Denials Director.  We started having weekly Revenue Integrity meetings and just recently started rotating RI meeting with a Denials meeting.  So we have started bring all denial issues to the meeting every other week and continue to work on anything that comes in the interim.

  • virginialbryan@gmail.comvirginialbryan@gmail.com

    I would love to discuss the challenges anyone is facing in responding to denials and the types of denials you are dealing with. I would be happy to do a Team Call or WebEx if there are multiple people interesting in having a round table discussion.

    I recently took a new job. We are discussing development of new services. One of those services is around denials. If you are willing to discuss further please contact me at virginia.bryan@cgi.com.

    Thank you.

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