Healthcare Denials Management


The way your organization handles its healthcare denials management process greatly impacts its bottom line.

The way an organization manages denials has a major influence on its financial base. An effective denial management strategy enables staff to identify trends and take proactive, corrective action. Since healthcare revenue cycle ultimately involves all departments of an organization, it is important to also expand denial management processes to all departments. Few organizations have a complete, all-inclusive denial management initiative. 

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senior RCM reimbursement specialist
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Improve Your Denial Management Process

With some proactive steps that will also increase your net patient revenue



Determine which denied claims should be given the most importance based on dollar value and volume. Also, identify the top ten types of denied claims and look for any common or recurring patterns in order to save time in the appeals process.



Finding and understanding the root cause of which the claims are being denied will help coders and billers correct the claim and receive reimbursement. Identifying the errors early on will also reduce future denials by preventing the same error to occur again.



Once you have identified the issues, decide the solution to prevent more denials and create an implementation strategy. Make necessary corrections in all billing and coding areas, as well as any software changes. Create a checklist of all documents and information needed before filing an appeal.



The Revenue Masters Difference

Because your contracts are all modeled in Revenue Masters software, we don’t just rely on 835 remits like most healthcare contract management systems. 835 remits reflect the payer decision to pay or not to pay. Since payers use incorrect and dated rates, don’t update renegotiated rates, apply inappropriate discounts, downcode claims inappropriately or simply don’t follow their contractual agreement, the 835 remits can many times reflect incorrect data.

With Revenue Masters you see exactly why it was denied and what to do next to successfully overturn your denials.

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RMReimbursement Maximizer

RMReimbursement Maximizer is a cloud-based denial management solution, allows providers to collect more cash more efficiently. It combines the clinical and financial documentation in a single source view, which reduces the time staff spends toggling through legacy systems looking for needed documents and problematic claims. RMReimbursement Maximizer also guarantees accuracy and efficiency in the appeals process by automating data entry, copy and paste, and choosing the correct appeals verbiage.

For more information about RMReimbursement Maximizer and denial management strategies and appeals, free to call us at (877) 591-2590 or email us at

Click below to learn more about the benefits of RM Contract Management for denials management in healthcare.

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