Using Data to Stop Errors Before They Happen
- Claim denials are costly but predictable, mostly caused by repeat data, coding, and payer-rule errors.
- Predictive denial tools flag risky claims before submission using past data and payer patterns.
- Systems score claims, auto-fix simple issues, and guide staff on complex corrections.
- Benefits include fewer denials, faster payments, lower labor costs, and better compliance.
- Start small with clean data, pilot by payer or clinic, and embed tools into daily workflows.
- Track success using denial rate, first-pass acceptance, days in A/R, and revenue recovered.