To proactively address claim denials, Wellstar Health System organizes monthly, cross-functional meetings that bring clinical and revenue cycle teams together to develop actionable countermeasures.
Organizational silos often prevent effective denial management, allowing repeat, preventable errors to continually disrupt cash flow.
To combat this, Kesiha Lewis, Executive Director of Integrated Authorization Services at Wellstar Health System, advocates for monthly, service-line-specific meetings that encourage collaboration between clinical and financial stakeholders. By utilizing data analysts to present concrete denial trends and case studies, these multidisciplinary teams can shift away from pointing fingers and focus entirely on developing actionable countermeasures.
Luke Gale is the revenue cycle editor for HealthLeaders.
KEY TAKEAWAYS
Organize monthly denial meetings by service line, ensuring representation from operations, coding, authorizations, utilization management, and providers.
Have data analysts present specific denial trends and case examples to anchor the group discussions around root-causes.
Use these collaborative forums to equip department leaders with the insights needed to educate their frontline teams and build accountability.