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Latest Technology In Denial Management

Latest Technology In Denial Management

Nexsys was fortunate to be invited to address the Innovation Conference for the annual HBMA Technology Showcase. We shared our experience and the solutions we found in DocVocate and their platform, Appelio, to demonstrate the technological advancements revolutionizing the denials management process and improving healthcare revenue cycle outcomes for Independent Physicians.

Automation and Workflow Optimization

Automation and workflow optimization are key elements in the latest technology for denial management. By automating repetitive tasks and optimizing workflows, revenue cycle management companies can streamline their denials management process and improve efficiency, which ultimately benefits our independent Phsysican clients.

Advanced software and tools automatically identify denials and assign them to the appropriate staff members for resolution. This eliminates the need for manual tracking and ensures that denials are addressed in a timely manner.

Additionally, workflow optimization allows for better collaboration among different staff and teams involved in the denials management process. By streamlining communication and providing real-time updates, Nexsys can improve its response time, reduce the overall denial rate, and, more importantly, reduce revenue leakage for our clients.

Overall, automation and workflow optimization plays a crucial role in improving the denials management process and reducing costs associated with denials.

some more points about Automation and Workflow Optimization

Data Analytics for Denials Trend Analysis

Data analytics has revolutionized the way we analyze denial trends and identify areas for improvement. By leveraging advanced analytics tools, we gain valuable insights into the root causes of denials and develop strategies to reduce and avoid them.

With data analytics, a unique strength of Nexsys Billing and Practice Management, we can analyze large volumes of data related to denials, including information about the types of denials, denial rates, denial reasons, and more. This data can help identify patterns and trends that may not be apparent through manual analysis.

By understanding the underlying causes of denials, we can implement targeted interventions and process improvements. For example, suppose data analytics reveals that a specific payer consistently denies claims for a certain procedure. In that case, we can take steps to address the issue, such as improving documentation or negotiating with the payer. However, it starts with the data to support the findings, sharing that with the client to make them aware of the trend, and then mapping a way forward that makes sense for both parties. 

Data analytics also enables Nexsys to track the effectiveness of its denial management strategies over time. By monitoring key performance indicators (KPIs) and analyzing trends, we can make data-driven decisions and continuously improve our denial management processes.

In conclusion, data analytics is a powerful tool for denials trend analysis, Nexsys, and revenue cycle management companies with valuable insights to improve their denials management process and enhance revenue cycle outcomes.

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About the Author: Jeff Robertson, CMPE, FMC

Jeff Robertson, CMPE, FMC
A passion for Healthcare is the best way to describe Jeff Robertson. He has a unique, varied and extensive background in Healthcare that covers a wide array of experience encompassing 30 years. Jeff is board-certified by the MGMA as a Medical Practice Executive (CMPE) and Financial Management Certified (FMC) and a proud active MGMA member. Jeff is also an active member of the Healthcare Business Management Association (HBMA) and continues to keep his knowledge current and focused on future trends and initiatives and how they affect our clients and their Clinics. Jeff has been actively running the Revenue Cycle Management and Practice Management divisions since 1997. Jeff Robertson has spent over 27 years in Independent Physician Clinics with a special focus on Medical Billing/Revenue Cycle Management, Healthcare IT, Clinical Workflow Analysis, and Medical Bookkeeping and Financials for Independent Medical Practices. His passion for teaching, consulting, and finding a better, more efficient way to build processes into a clinic has led to him being labeled the “Practice Fixer.” To date, he has installed, configured, trained, and consulted over 400 Independent Physician Clinics across the country and has learned valuable lessons from each of them to share with all future clients.