What does the term "denial management" primarily aim to achieve?

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Denial management primarily aims to maximize revenue collection within healthcare organizations. This process involves identifying, addressing, and resolving issues that lead to claims being denied by payers, such as insurance companies. When claims are denied, healthcare providers lose potential revenue that affects their financial stability and ability to deliver services. By effectively managing denials, organizations can resubmit corrected claims, appeal denied ones where applicable, and ultimately ensure that they receive appropriate reimbursement for the services rendered. This practice not only helps in improving the revenue cycle but also aids in analyzing patterns that may prompt denials, allowing organizations to implement necessary changes to reduce future denials and enhance overall financial performance.

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