Analyzing the root-cause behind denials
When a claim is denied, it is important to understand the root-cause issue rather than working to get the claim paid
Decision Making
Once you have found the underlying issue behind the denial, all you have to do is decide how the issue can be fixed permanently so that you will not encounter such denials again.
Corrective Measures
Prepare a checklist, collect all necessary information and / documents and make calls if needed.
Document the solution
When the claim gets paid, immediately document the solution that aided payment of the claim and communicate it to peers who work on denial management so that everyone is aware of the solution to the issue.