HealthStream offers performance learning management solutions to help develop your healthcare staff into leaders and reduce turnover.
View All ProductsHealthStream works with healthcare organizations to create engaging and high-quality training videos for your staff and management.
View All ProductsImprove care quality and save money by making informed decisions about your healthcare facility and staff with HealthStream's reporting analytics solution.
View All ProductsHealthStream's proven methods for the improvement and overall engagement of your healthcare staff foster a positive workplace and increase retention rates.
View All ProductsBe confident in your staff’s ability to reduce risk by providing compliance training that changes behavior.
View All ProductsDevelop next-level people for next-level care by prioritizing quality and safety improvements.
View All ProductsEstablish a culture of belonging with education supporting DEI, wellness, engagement, and leadership development.
View All ProductsDeliver custom or industry designed product training directly to patient and resident care environments to reinforce proper use.
View All ProductsStop wasting money on RCM issues. Learn how to Provide your team with expert-led revenue cycle training to help them reduce denied claims, reimbursement mistakes, and more.
View All ProductsLearn about our advanced resuscitation training solutions. Our solutions are designed to help improve patient outcomes.
View All ProductsUnlocking the full potential of clinicians goes beyond aspiration – it’s a commitment we embody. Our competency development solutions help personalize learning for every clinician so you can confidently bridge the gap between theory and practice for your nurse residents while meeting the unique development needs of your seasoned clinician.
View All ProductsEnhance maternal & child nursing care with solutions focused on improving the quality of care for mothers, infants, and children.
View All ProductsAddress staffing challenges, standardize orientation and onboarding, and deliver an effective training program for your team to easily achieve and maintain certification with our critical, emergency, and acute care solutions.
View All ProductsWe understand the critical importance of earning and maintaining your patients' trust in the delivery of exceptional sedation and surgical outcomes. As a premier provider of healthcare education, we are committed to empowering you in promoting safer, more successful outcomes for each and every patient, without exception.
View All ProductsOur solutions are meticulously designed to cater to the diverse needs of patients, healthcare professionals, and organizations. Within this innovative framework, we have curated specialized subsets of solutions aimed at addressing the ever-evolving challenges faced by individuals dealing with illnesses or chronic conditions.
View All ProductsHealthcare workforce management is essential. We provide advanced scheduling solutions for organizations to solve issues such as nurse retention
View All ProductsTackle all the challenges of practitioner directory management within a health plan with a single solution tailored to your specific needs.
View All ProductsOur affordable CVO credentialing services establish patient safety by enabling primary source verification for your healthcare organization.
View All ProductsFinally, a comprehensive resource to support collecting, storing, and sharing credentialing data with ease.
View All ProductsIntegrate with Epic to validate and add new providers directly to your provider master file.
View All ProductsMitigate risk and elevate your quality of care. Improving both clinical and business outcomes starts with a smarter, more integrated approach to regulatory training, continuing education and quality management.
Learn MoreManaging denials is a critical aspect of the revenue cycle for healthcare organizations, yet it often feels like navigating a maze full of obstacles. The challenges in denials management can include complex coding errors, lack of proper documentation, and insufficient understanding of payer requirements. These challenges not only affect revenue but can also increase administrative burdens on your staff, leading to frustration.
The trend is not new -- in a pre-pandemic survey, the American Hospital Association found that 89% of respondents indicated their facilities had seen an increase in claims denials from 2016-2019, with 51% of those characterizing the increase as “significant.” Many respondents indicated the significant costs in dealing with denials management, including one 17-hospital system that spent $11 million annually just to ensure they met requirements for prior authorizations, a main cause of denials1. To improve denials management, it’s essential to adopt a proactive approach. Here are a few basic steps to jump-start a new implementation plan:
Remember, improving denials management is not just about process; it’s about empowering your team and creating an environment where they feel supported to succeed. By identifying and addressing the root causes of denials, you can not only prevent future denials but also enhance overall revenue cycle management. Furthermore, implementing denial prevention strategies, such as upfront eligibility verification and pre-authorization processes, can significantly reduce potential denials. And with advancements in technology, there are now tools available that streamline the claims process and identify areas for improvement.
However, with all the tools available to assist in claims denial management, a well-trained staff is an integral part of the solution. Providing ongoing training on payer requirements and claims submission, as well as best practices to leverage the data from today’s technologies, can minimize dollars lost to denials.
While managing denials may seem like an overwhelming task, it's important to remember there are many opportunities for improvement within this process. By taking a proactive approach, providing necessary resources and support to your team, and constantly evaluating and adapting to changes, you can improve denials management and see positive impacts on revenue and operational efficiency.
Learn more about HealthStream’s Revenue Cycle Education offerings.
HealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All Learning & PerformanceHealthStream offers performance learning management solutions to help develop your healthcare staff into leaders and reduce turnover.
View All ProductsHealthStream works with healthcare organizations to create engaging and high-quality training videos for your staff and management.
View All ProductsImprove care quality and save money by making informed decisions about your healthcare facility and staff with HealthStream's reporting analytics solution.
View All ProductsHealthStream's proven methods for the improvement and overall engagement of your healthcare staff foster a positive workplace and increase retention rates.
View All ProductsWhen you enact HealthStream's quality compliance solutions, you can do so with the confidence your healthcare organization will meet all standards of care.
View All Quality & ComplianceBe confident in your staff’s ability to reduce risk by providing compliance training that changes behavior.
View All ProductsDevelop next-level people for next-level care by prioritizing quality and safety improvements.
View All ProductsEstablish a culture of belonging with education supporting DEI, wellness, engagement, and leadership development.
View All ProductsUtilize patient access solutions and advanced reimbursement solutions to manage clinical denials and improve your organization’s reimbursement strategy.
View All ReimbursementExpand the decision-making skills and effectiveness of your healthcare workforce with HealthStream's clinical development programs and services.
View All Clinical DevelopmentLearn about our advanced resuscitation training solutions. Our solutions are designed to help improve patient outcomes.
View All ProductsUnlocking the full potential of clinicians goes beyond aspiration – it’s a commitment we embody. Our competency development solutions help personalize learning for every clinician so you can confidently bridge the gap between theory and practice for your nurse residents while meeting the unique development needs of your seasoned clinician.
View All ProductsEnhance maternal & child nursing care with solutions focused on improving the quality of care for mothers, infants, and children.
View All ProductsAddress staffing challenges, standardize orientation and onboarding, and deliver an effective training program for your team to easily achieve and maintain certification with our critical, emergency, and acute care solutions.
View All ProductsWe understand the critical importance of earning and maintaining your patients' trust in the delivery of exceptional sedation and surgical outcomes. As a premier provider of healthcare education, we are committed to empowering you in promoting safer, more successful outcomes for each and every patient, without exception.
View All ProductsOur solutions are meticulously designed to cater to the diverse needs of patients, healthcare professionals, and organizations. Within this innovative framework, we have curated specialized subsets of solutions aimed at addressing the ever-evolving challenges faced by individuals dealing with illnesses or chronic conditions.
View All ProductsMake sure your healthcare staff can schedule out appointments and work schedules with ease using HealthStream's line of software solutions.
View All SchedulingHealthcare workforce management is essential. We provide advanced scheduling solutions for organizations to solve issues such as nurse retention
View All ProductsComprehensive, industry-leading provider onboarding and credentialing software that validate health outcomes and support provider assessment.
View All CredentialingOur affordable CVO credentialing services establish patient safety by enabling primary source verification for your healthcare organization.
View All ProductsIntegrate with Epic to validate and add new providers directly to your provider master file.
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