Included with BridgestoneHRS Web-based Denials Management Software (Web-DMS) is our DENIALS WORKSHOP.
The Denials Workshop is designed to provide management a complete and current understanding of all their Denied Charges.
Ideally the Denials Workshop is scheduled once a month, but can be held as often or infrequently as necessary.
Our expert staff of denial analysts reviews the client’s data and identifies trends, opportunities and areas of concern. The data is then summarized and presented to the facility in a concise and easy to understand manner.
The Denials Workshop can be considered the brains of the Continuous Quality Improvement Process.
Measure -> Analyze -> Implement -> Measure -> Analyze -> Implement
With the regular use of the Denials Workshop a facility will always know exactly where are its areas of “opportunity”.
We don’t simply present the data but offer suggestions on ways to stop the denied charges from occurring in the first place.
Here is an example:
BridgetoneHRS reviews the client’s data and can see in the last 30 days the facility has seen a 30% increase in Denied Charges for Eligibility related reasons compared to the previous 30 days.
Here is what we will check for:
- Is the increase in Denied Charges due to just a couple “big ticket” accounts being denied? If yes then this suggests there is not an unusual problem in the system.
- Is there also an increase in the number of accounts which are denied for these reasons? If yes, that implies there is a problem somewhere. It could be a software issue, personnel problem or something else.
- Is this increase seen by all payers or just one or two? If it is all payers that implies this could be a user or software issue.In the Denials Workshop this issue will be presented to the management with the data to support the observations.The “opportunity” is presented in a concise form and management is encouraged to provide their input. We have seen many examples of situations as described above and the solution turns out to be as simple as training a new team member.
The facility would probably have realized they had an eligibility training issue related to one of their staff members, but it could have taken months to become apparent.
With the Denials Workshop a facility will know at the earliest possible time of a problem and have a very clear insight as to the required steps to resolve the issue.
Feel free to contact us at (619) 920-6147 or email@example.com if you would like more information.