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Track and manage disputed claims to prevent recurrence

Managing disputed claims costs provider organizations significant time and expense. Dallas-based Tenet Healthcare Corporation has taken some of the pain out of the process with a structured disputed claims management program that focuses on preventing recurrences. In the process, the company has recovered more than 50% of disputes from most of its top 10 managed care payers and nearly half of all other disputed claims. Tenet operates 57 hospitals in 12 states. Most use a centralized patient financial services (PFS) structure, with a central business office handling the hospitals in each of five regions, explains Terry Heichelheim, director of dispute management in the company's PFS department.