New approach to denials
Case Management Weekly, October 16, 2007
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A hospital in West Virginia claims a new approach to appeals has improved its denial reversal rate from 50 to 80%. Since centralizing the handling of denial notices under the case management team, West Virginia University Hospital says turnaround times have also fallen, with physicians actively participating in the appeals process.
"Our denials were falling through the cracks," admits director of care management Christy Whetsell. "Nobody really knew what to do because we lacked a protocol and didn't have a solid system in place.
"Centralizing our denials has improved the speed in which we submit and track denials, and has enhanced everybody's awareness about their part in denial management."
The full story on the transformation in West Virginia is in the latest issue of Case Management Monthly, HCPro, Inc. Read and subscribe online, at Case Management Monthly
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