Revenue Solutions Denial Prevention
Healthcare organizations continue to experience inefficiencies and revenue leakage as a result of recurring denials. FTI Consulting uses proven techniques and technology to identify root-cause issues and resolve deficiencies before they arise, resulting in increased net revenue, minimal manual intervention, and reduced claim cycle time.
FTI Consulting’s denial prevention program consistently produces sustainable cost reductions and financial benefits. Our typical range of benefit is 1 percent to 2 percent of net revenue improvement over a 12 to 18 month implementation period. Our subject matter experts recognize that true reduction in denials requires the engagement of all stakeholders. Our coordinated approach to performance improvement and program design is based on the following model:
Denial Prevention: Using 835 data, we quantify preventable denials, map the opportunity to payers and departments, and identify root‐causes. The analysis isolates opportunities to resolve system issues, improve processes, and identify educational opportunities for staff to reduce bill edits, payer rejections, and denials.
Denial Management: Using either the current patient accounting system or additional bolt‐on technology, FTI Consulting experts develop best‐practice strategies to improve automation and efficiency in processing denials and appeals. We perform detailed ANSI mapping analyses to reduce inefficiencies and enhance prioritization of collectible high impact denials.
Reporting: In order to ensure sustainability, we develop multi‐level dashboard reporting to allow leadership to monitor key denial trends with account level detail at the push of a button. Dashboards enhance operational transparency and display problematic areas with denials and accounts receivable, providing the tools to address specific areas of focus. Our teams are focused on tangible and actionable solutions that meet the needs of any type of provider or organization.