A Look Into the Crystal Ball: Revealing the Future of Denials Prevention - HBMA Store

A Look Into the Crystal Ball: Revealing the Future of Denials Prevention
Presented by Linda Perryclear

As presented at HBMA's 2024 Fall Conference September 17th-19th, 2024.

Description:
It’s estimated that 80 to 90 percent of denials are preventable, yet preventing denials continues to be one of the biggest challenges for providers. While countless hospitals, health systems and provider practices may have denials management processes in place, there are limitations with existing editing solutions. Given the manual nature of the tools, these solutions prove to be time-consuming and costly, with estimates as high as $150 to rework a single denial. 

Thankfully, artificial intelligence – which thus far has been a game changer within the healthcare industry - can be used to improve denials prevention and reveal new revenue-growing opportunities. In this presentation, RCM experts from Availity will discuss how AI can be used to precisely predict denied claims and examine the associated causes before claim submission.

There is no magic potion that can completely prevent denials, but proactive steps can be taken to limit the number of denials and retain reimbursements. While no one can predict the future, we can share the benefits of incorporating AI your organization’s claims editing process to accurately predict denials before they occur and improve your revenue cycle management.

Learning Objectives
Course participants will be able to:

1. Acquire insider knowledge detailing what the future holds for denials management and reasons why proactive prevention with an AI-powered solution is a critical component of any revenue cycle.
2. Gain insight into the benefits of leveraging forward-thinking editing tools to predict denials before they happen, plus gather actionable denials management insight that your organization can implement in the near future.
3. Hear real-world examples and success stories that illustrate AI’s importance in the denials lifecycle, plus walk through predictive models detailing how a large health system with six million dollars in annual claims can realize potential annual savings of $1.7 million.