How Is Denial Management Changing?

by | Feb 13, 2019 | Healthcare

Latest Articles



One of the biggest obstacles for anyone remotely involved in the health care industry, whether they are a patient, a biller or a physician, is denial management in healthcare. This unfortunate phenomenon comes at the hands of insurance companies that are so unwilling to compensate for certain claims that they find any possible reason to deny a claim and save money. In fact, countless health insurance companies have shrouded their policies in all sorts of complicated rules to ensure they have to surrender as little money as possible. Working with a skilled professional is the only way to ensure for effective denial management in healthcare, thanks largely to the efforts of governmental healthcare reform.

A Safety Net for Physicians

The arrival of the Affordable Care Act brings several safety measures to ensure physicians and patients become far less likely to run into issues with insurance claim denials. This comes in the form of several new rules meant to work around the loopholes insurance companies set in place to keep from having to pay out. One such rule includes HIPAA protocols.

Stronger HIPAA Protocols

The ACA has delivered an amendment to HIPAA policies known officially as the HIPAA 5010. This changes the filing process for transactions and claims, converting them so they are entirely digital and easy for medical staff to access whenever needed. Having these records more readily on hand makes it easier for professionals to combat against insurance denials.

This is also where the work of medical coders comes most distinctly into play. The vast majority of coders and billers have the expertise needed to navigate denial management in healthcare. In some cases, their efforts can boost overall revenue by 10 percent. To learn more about potential effective strategies for denial management in healthcare, get in touch with GeBBS Healthcare Solutions by calling 888-539-4282 or visiting their website.

Similar Articles