Survey reveals 5 opportunities to tackle denial prevention and management

 

Organizations that devote greater resources to denial prevention see lower first-pass denial rates, a recent survey shows, but most steer more staff toward back-end denial management.

When it comes to denial management, 31% of healthcare finance professionals say their organizations are most focused on denial prevention — but that’s not where they’re putting the majority of revenue cycle resources, according to a recent HFMA survey.

The survey, sponsored by Waystar, a leading healthcare payments technology company, indicates nearly half of organizations (49.5%) allocate most of their denial-related resources toward back-end revenue cycle tasks like managing denials and submitting appeals. Just 17.3% devote more resources to front-end tasks focused on denial prevention. The difference between perception and resource-backed reality came as a surprise to revenue cycle experts, especially when compared with the decisions organizations are making around revenue cycle technology investments.

“We’re seeing success among clients that address the root cause on the front end and implement automation and intelligence to help their revenue cycle staff prioritize the work,” said Matt Hawkins, CEO, Waystar. “This approach enables providers to dedicate more time to higher-impact efforts and patient care.”


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