More importantly – how much are you losing per month due to denials?
Handling denials due to eligibility
When you find out that there are eligibility related issues, put these patient appointments in an “appointments at risk” bucket.
Handle denials due to coverage issues
Simply having coverage on the date of service is not enough. Your eligibility team needs to find out whether the service is covered by the patient’s benefits as well.
Handling prior authorization related denials
If you find out that a procedure requires prior authorization by the patient’s plan, immediately move the appointment to an “appointments at risk” bucket.