Culbert Blog Work Claim Denials More Efficiently Using Owning Areas: Epic Resolute Hospital Billing

In most cases, payer denials are investigated and resolved through the functionality of Account Workqueues. Traditionally, Account Workqueues are separated by Payer or Payer Financial Class along with an account alpha-split for larger organizations to help manage staff workloads. This type of configuration results in all denials from the same payer qualifying for the same workqueue. While there can be advantages to having a payer-specific focus, this is not always the most efficient or effective way to resolve denials as the staff assigned to these workqueues may have significantly different skillsets and experience levels. A new Epic design option, based on Owning Area, is now available for HB users which can improve the AR follow-up process and staffing efficiency. Within the Remittance Code masterfile (RMC), it is now possible to assign an Owning Area to each denial code. This allows you to reconfigure your Account Workqueues to group claim denials for follow-up by billing staff based upon their specific expertise, such as authorization, medical necessity, coding for correct reimbursement, attachment required, etc. You may also choose to route some denials to less-skilled, lower-cost staff for resolution allowing your more experienced people to focus on the more complex situations. Note that [...]The post Work Claim Denials More Efficiently Using Owning Areas: Epic Resolute Hospital Billing appeared first on Culbert Healthcare - CHS.