I often ask my clients “Are you in Denial about your Denials” whereby the following questions are asked:

* Are you maximizing your commercial and managed care recovery?
* Do you track Denials by payor and the Reasons for Denials?
* Do you know what your Denial Rate is?
* Do you know what your Denial Recovery Rate is?
* Have you established a Remittance Management process?
* How quickly do you turn your denials back into cash?

In the January 25th issue of Health Leader Media Finance their is an article titled “Denials Bleed You: Four Ideas to Fix It” by Karen Minich-Pourshadi. In her article she states that claims and denials and underpayments are one area that few CFO’s would dispute they could always use improvement and that 90% of denials may be preventable through improved execution of verification, authorization and documentation. She also offers four ideas to fix it which I believe are worth reading because they are the exact same ideas that I have been telling CFO’s and Managed Care Directors for years. They are not that difficult to implement and there are several consultants like myself that will help with implementation and methods to stop the bleeding. But then again I wonder if CFO’s are now believing that the current Health Care Reform Bill will stop the bleeding.

Bruce Jacobs
Director, Financial Management Services
http://www.inteck-inc.com/fms.htm