In this complex and rapidly changing claims denial environment, providers must take a proactive approach to stay ahead of the game. Here’s what providers can do to successfully navigate the audit landscape.
When I recall playing tug-of-war in the schoolyard, it brings back feelings of struggle and fatigue. Despite all the energy being exerted, it seemed like you just couldn’t make up much ground. Even the rope would start to feel like part of the fight.
Amid the pandemic, the push and pull with payers over claims denials has many providers feeling similarly worn out. Unfortunately, from a revenue cycle perspective, it’s just getting started. Payers are still catching up from 2020 denials thanks to Covid-19, CMS continues to change regulations, and evolving paradigms of value-based care are raising new complexities. All the while, providers are short on resources and need to bring in every last dollar.
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