The RCxRules Blog

The Compounding Benefits of a Proactive Approach to Denial Management

Staying on top of denial management can feel like a never-ending spiral. Addressing billing and coding errors only after they’ve resulted in a denial is a tedious process that requires a lot of manual labor just to keep from falling behind. Taking a proactive stance can change the game and help medical groups create a dramatically more efficient workflow that continues to improve month after month.

By cleaning data at the beginning of the process, immediately after it leaves the EMR and before a claim is created, medical groups can create a continuous improvement model. Getting ahead of a billing or coding issue doesn’t just mean that a coder is saving time by not needing to address a denial down the line—it’s an opportunity to proactively address this issue through automation every time it reoccurs.

Examining the issues that were addressed each month enables groups to determine what rules can be created to fix these errors and automate the manual correction processes for every future instance. As these rules accumulate, more and more processes become automatic, and countless hours of manual labor are saved. The benefits continue to compound as more new rules are created.

In addition to creating their own unique rules to address specific payer requirements, RCxRules users also have access to our ever-expanding rule library. RCxRules has a coding team that is constantly updating and adding to this library based on the latest coding developments. This team also works closely with our customers to learn about new rules users are implementing that could be of use to other groups. Through this rule library, users can benefit from the knowledge and experience of similar medical groups to improve their own processes.

By turning their own organizational knowledge into automated rules and leveraging the rule library, RCxRules users can end up with an arsenal of thousands of rules. Every time they onboard a new billing or coding employee, that employee is immediately able to access this immense knowledge bank, which can significantly streamline the onboarding process. It also helps ensure continuity—there’s no risk of losing progress when someone leaves the organization and takes their notes and internal knowledge with them.

To learn more about implementing a proactive approach to denial management, set up a 15-minute meeting today.



Get the latest updates

Receive insights on value-based care, revenue cycle best practices and more!