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The Winning Edge: Tackling the Denials Dilemma

Analysis  |  By Eric Wicklund  
   January 17, 2025

Denials are a major pain point for revenue cycle leaders. Here’s how to manage—and perhaps even prevent—them.

In the latest installment of HealthLeaders’ The Winning Edge webinar series, Beth Carlson, VP of Revenue Cycle at WVU Medicine, explained how denials are impacting the entire health system, from RCM down through provider to patients. That’s why denials management, she says, requires a collaborative approach.

Carlson says she’s working with the financial, legal and clinician departments to not only better understand why denials happen and what to do when they happen, but to move upstream and identify how to prevent them in the first place. She’s also using new technology, like AI, to understand payer and provider trends and patient financial options and collaborate with payers to integrate clinical care pathways with payer policies.

Tune in below to hear how Carlson is addressing denials management.

 

Eric Wicklund is the associate content manager and senior editor for Innovation at HealthLeaders.


KEY TAKEAWAYS

Denials are a key pain point in healthcare, and today’s RCM leaders need to address them with collaboration and technology.

Forward-thinking RCM leaders can use data to better understand payer trends and policies, provider tendencies and patient financial burdens and create a denials management strategy that improves the process and even identifies tactics for preventing denials.


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