What is "denial management" in health care finance?

Denial management refers specifically to the processes and strategies used to address denied insurance claims. In health care finance, this involves identifying claims that have been rejected by insurers and working diligently to resolve the issues that led to the denial. This process is crucial as denied claims can negatively impact a healthcare facility's revenue cycle. Effective denial management includes analyzing denial reasons, retraining staff as needed, appealing denied claims, and ensuring that future submissions are accurate and compliant with insurance requirements. By focusing on resolving these denials, healthcare organizations can enhance their revenue and sustain financial health, making it a vital component of their financial management strategy.