What does denial management entail in Epic Resolute PB?

What does denial management entail in Epic Resolute PB?

• A. Processing payments for approved claims
• B. Tracking, appealing, and resolving denied claims
• C. Creating patient billing statements
• D. Managing payment plans for patients

Answer: (B)

Denial management in Epic Resolute Professional Billing focuses specifically on tracking, appealing, and resolving denied claims. This process is crucial for ensuring that the practice recovers revenue that it is entitled to by addressing any issues that prevent claims from being approved by payers. Effective denial management involves analyzing the reasons for denials, coordinating with clinical and insurance representatives to gather the necessary information, and submitting appeals when appropriate to overturn the denials. This aspect of revenue cycle management is vital, as it directly impacts cash flow and the financial health of the practice. By actively managing denied claims, the practice can improve its revenue cycle efficiency and increase the likelihood of prompt payment for services provided.

Denial management in Epic Resolute Professional Billing focuses specifically on tracking, appealing, and resolving denied claims. This process is crucial for ensuring that the practice recovers revenue that it is entitled to by addressing any issues that prevent claims from being approved by payers. Effective denial management involves analyzing the reasons for denials, coordinating with clinical and insurance representatives to gather the necessary information, and submitting appeals when appropriate to overturn the denials.

This aspect of revenue cycle management is vital, as it directly impacts cash flow and the financial health of the practice. By actively managing denied claims, the practice can improve its revenue cycle efficiency and increase the likelihood of prompt payment for services provided.