Matt Fisher, Revenue Cycle Director of the Customer Solutions Center at Piedmont Healthcare, discusses how commercial insurers' high denial rates affect the patient experience and ways hospitals and health systems should adjust their strategies accordingly.
How can providers create a better patient experience given insurers' high denial rates?
Matt Fisher: “I think some of the necessary tips that I would offer for managing the denials process is to keep the patient informed and keep them in the loop through that process as the denials process continues to progress. Many times, we find that denials can take months, if not years, to resolve. If you leave the patient out of the loop through those processes, then it can result in a poor patient experience on the back end when the patient is stuck receiving a bill a year or more after the date of service. So when we keep the patient involved through that (appeal) process, the patient feels informed. We are being transparent through the process as well (on where delays are occurring).
"Taking a collaborative and informative approach with the patient and keeping them involved throughout the process also has shown great success on our end in resolving some of those complex denials. There are times when we need the patient's involvement in resolving those denials, particularly around coordination of benefits denials."
