Montage Health improved from an initial denial rate of 9% to 6.5% in one year. Here are the tactics they used.
What are the cornerstones of your organization's denial management success?
Geneva Stewart: “Really good collaboration across the organization that led to denials prevention. About 86% of denials in the industry are reported as controllable. So we focused on these controllable denials, and that focus really turned out well for us. We went from a 9% initial denial rate in 2022 to 6.5% in 2023.
"And we're still working to move that needle and continue to reduce denials. Some of the cornerstones for this success have been getting everyone engaged and calling out deenial root causes through the data mining that we do. Our revenue cycle team gets together with other departments on dashboard calls. We identify and monitor the top trends and really do a lot of work around prevention education, coding and documentation competency checks, and analysis of critical errors. Our data-guided focus remains on stopping similar claims (around root causes) before they get billed."
