Clinical denials: Prevention is the best medicine
from Becker's Hospital CFO Report
Clinical denials are a fact of life for hospitals. Providers must contend with a number of government audits conducted by several different organizations. On the private payer side, hospitals must comply with complex approval processes related to prior authorizations, admission status and medical necessity. Collaboration between physicians and utilization and revenue cycle leaders can minimize clinical denials and maximize payment for hospital services.
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