Mythli Mukundan, AVP Revenue Integrity at WVU Medicine, shares how it truly takes a village when positioning your organization for denial management success.
What type of team best supports effective denial management?
Mythli Mukundan: “In revenue cycle, we have found ourselves addressing a lot of gaps. And these gaps could be due to regulatory changes, changes in (payer) behavior, or things that have happened process-wise internally. And in order to resolve these gaps and stop revenue leakage, we have to put in a system-level fix. In all of these cases, it is very imperative to have a good foundation for a strong collaborative partnership, both within the revenue cycle and across the health system.
“Within the revenue cycle, that means across your billing teams, your front-end auth team, your patient access team, denials management, and contract validation.
“And outside of revenue cycle, we need to partner and collaborate heavily with a variety of stakeholders: Our clinical departments. We must also partner closely with our payer contracting team to keep them informed about the ongoing changes within our landscape. And legal. We need to ensure the legal team is aware of when we need their help. And last but not the least, our vendor relationships. Our vendors are a partner in this with us. And together––all of us––both internal and external, we will build a strong foundation for our revenue cycle.”
