American Health Network Reduces Denial Management Time by 75 Percent, Realizes ROI of 200 Percent

Posted on August 29, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Ever since I first attended HFMA’s ANI conference, I’ve been fascinated by the opportunities available in managing a hospitals revenue. There are so many areas where even a small change to your operations directly effect your bottom line. That’s the beauty of any revenue solution.

Thus, I was quite interested to read this whitepaper about American Health Networks experience reducing claim denials. American Health Networks realized an ROI of 200 percent and recovered $1.4 million by changing their denial management practices.

I especially like how American Health Networks chose to roll this out first as a pilot program to a small subset of doctors. Then, after evaluating the results they chose to roll it out to the whole organization. Far too often I see organizations try to go all in with a solution and then fail miserably. There’s a lot of value of rolling out any IT solution to a small set of engaged users before applying them to the whole organization. One of the biggest values of this is the pilot group of users becomes the product champions once you’re ready to roll it out to the whole organization.

There are a lot of places where revenue is figuratively leaking out of healthcare organizations. For many organizations, claim denials is one of those places. I’d love to hear what solutions people have implemented to address claim denials in their organizations.