Accounts Receivable Management Tips for Healthcare: It’s Time to Standardize Your Metrics for Denial Management

Accounts Receivable Management Tips for Healthcare: It’s Time to Standardize Your Metrics for Denial Management

Claim denial rates are still a major concern for accounts receivable management in 2022. For example, denial rates for marketplace payers have reached rates as high as 80% according to the Kaiser Family Foundation [1]. But this is only the beginning. COVID has put upward pressure on denial rates for a while now. All of this means that revenue cycle leaders should be taking a fresh look at their denial management practices, not only considering accounts receivable management services but also seeing this as an opportunity to investigate new and more effective approaches to denial management.

CMS Updates DMEPOS Requirements

The Centers for Medicare & Medicaid Services (CMS) has added 31 items and deleted 5 items on the Durable Medical Equipment, Prosthetics, Orthotics, & Supplies (DMEPOS) Master List. Additionally, effective April 13, 2022, CMS is selecting items beyond Power Mobility Devices (PMDs) that require a face-to-face encounter and written order prior to delivery as a condition of payment.

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