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Scenario 1: Denials The Chief Financial Gtcer iCF] has expressed a concern with the increasing number of denials. A team consisting of individuals from li'tdmissionsI
Scenario 1: Denials The Chief Financial Gtcer iCF] has expressed a concern with the increasing number of denials. A team consisting of individuals from li'tdmissionsI Utilization Management. EDI, Coding and Billing have been assigned the task of studying the denials to determine some action steps to improve the process. The KPI for denials is 4%, however, the current rate is 10%- The CFD wants to see a drop in the rate to 3% within the next 45 months and another reduction to 6% within the year. Tips: ' Consider why the CFO chose these departments to participate on this team. ' Think about their roles and responsibilities that could be a factor if the task is not being performed effectively or at all. ' Research effective management of denials. Question: 1What are 3 possible causes for denials from these areas
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