Denial Management is one of the most important processes that can make or break the smooth functioning of a practice’s revenue cycle. There are two financial aspects to a denied claim – first is the “lost” revenue due to the improper prior authorization or the lack thereof and the second is the cost associated with reworking a denied claim, which entails a lengthy appeals process. Recent studies indicate that physicians spend anywhere from $30 to $100 or upward to rework a claim – costing the practice $14,400 (lowest estimate) annually based on 40 denied claims per month, not including the preliminary cost of submitting a claim.
