Improving Cash Flow in a Down Economy

CHICAGO, March 4, 2009—Healthcare providers seeking entitled reimbursement are being forced to reduce denied claims due to the struggling economy and ongoing changes in the workplace. This shift has triggered a need for health information management professionals to improve cash flow by contributing to revenue cycle management and ensuring claims are paid on the first submission, according to an article in the March issue of the Journal of AHIMA.

The root of the cash flow problem is not bad debt in which charges are unpaid by patients. Improving Cash Flow in a Down Economy explains that the problem can be traced to an earlier stage in the revenue cycle when denials are caused by administrative errors related to eligibility and failure to validate coverage for the services rendered, resulting in third-party insurers partially or totally denying claims.

This article discusses how the solution lies in improving the denial management process and how HIM professionals can leverage their expertise in documentation and coding to ensure error-free claims.

A sidebar identifies six areas that HIM professionals can improve the denial management process and help guarantee accurate claim submission to recover entitled reimbursements:

• Data analysis
• Charge review
• Training
• Back-end editing
• Documentation improvement
• Release of information

Read the complete article in the March issue of the Journal of AHIMA or online at journal.ahima.org.

About AHIMA

The American Health Information Management Association is America’s leading professional society whose mission is to “improve healthcare by advancing best practices and standards for health information management and [serve as] the trusted source for education, research and professional credentialing.” AHIMA represents more than 53,000 specially educated HIM professionals who serve healthcare and the public by managing, analyzing and utilizing data vital for health system management. www.ahima.org