Skip to main content

Why more utilization of data can lead to fewer denied claims

Denied claims negatively impact your financial performance, put more stress on your billers and hinder the patient experience. However, most denied claims can be prevented!

There’s no reason to let lost earnings continue to slip through the cracks, or to keep settling for delayed payments. With the right tools, you can immediately start improving your revenue cycle management process.

Not sure what your RCM process is missing? Keep reading to discover how using advanced analytics can increase your claims acceptance rates.


Monitor at-risk revenue

Revenue is at-risk of being lost when you have claims that are approaching the 12-month filing limit and when new claims have inaccurate or incomplete patient/payer information.

It’s hard to catch these things when working manually, but an advanced reporting tool can notify you of all the errors you need to fix. It generates the information you need to better prioritize payer responses and provides the visibility to monitor all at-risk revenue. This results in a major workflow shift from constantly playing catch up and fixing errors, to preventing mistakes in the first place, causing fewer denied claims.


Better understand workflow trends and needs

It’s necessary to monitor and work on previously denied claims in the same way it is to submit new claims. More importantly, there’s valuable data to gather from denied claims.

Pull performance reports on all your denials. The data provided should shed light on recurring billing errors and opportunities to better capture revenue. It will help you make sense of why claims aren’t getting accepted and identify workflow issues that need immediate attention. These insights have the potential to improve your clean claims rate, shorten A/R days and boost your bottom line.


Streamline and simplify performance reports

Performance reports are highly beneficial if used properly. Your team needs to focus their time on taking advantage of the key insights within reports, rather than gathering data and creating reports. They need an advanced reporting tool like ABILITY® EASE All-Payer.

When you simplify the creation of reports, you can dig deeper into what the data is telling you. This allows you to quickly start improving your denial rates, rather than wasting time on report generation.

If you’re constantly catching mistakes after a claim has already been denied or you’re curious why you’ve lost a certain amount of revenue start reading between the lines. Utilize the data available to you. Apply it to your workflow, share the insights with your team and strive to keep learning. Over time, your acceptance rates will reflect these efforts.

Discover our full suite of revenue cycle solutions more tools to streamline your revenue cycle and reduce denied claims.

Inovalon® and design, Inovalon® are trademarks of Inovalon, Inc.

About the author

David Swenson, Manager, Sales Engineering