Learn ways WVU is shifting processes to improve denials prevention.
Have you experienced any shifts in your denials management focus lately?
Leah Klinke: "We've always performed pretty well from a denial write-off perspective when you look at us compared to our peer groups, staying within the top quartile of denial write-offs. But we've found over the last year that payer denial behavior has increased so much that we've been having trouble keeping in that top quartile range.
"So over the last few months, we've been focusing more on denial prevention activities, mainly on authorizations and medical necessity denials. We've convened cross-sectional groups of front-end leaders as well as our back-end team to try to kind of “root cause” some of those denial areas and prevent missteps from happening. There are a lot of challenges in these areas, and we're really hopeful that these efforts will yield lower initial denials. Over time, this will prevent the need to appeal many of these denials on the back end."