Too many denied Medicare claims turn into uncompensated care and lost revenue. Learn where that loss starts and how to reduce it before it impacts your bottom line.
Thursday, June 4, 1 PM ET
Thursday, June 4, 1 PM ET
Denied claims rarely start as denials. They begin earlier with missed eligibility checks, incomplete patient or resident information, or secondary coverage that goes unidentified. These small front-end breakdowns often seem minor, but they create bigger issues downstream.
For Medicare providers, those problems are getting harder to manage. Coverage is more complex, prior authorization requirements are expanding, and Medicare denial rates continue to rise. In fact, 17% of Medicare Advantage initial claims are denied on first submission, and Medicare now reimburses hospitals just 83 cents on the dollar, resulting in more than $100 billion in underpayments annually.
In this 30-minute session, we connect the dots across the revenue cycle and show where revenue is slipping away, why it happens, and how to stop it earlier.
A recent study revealed 78% of revenue cycle leaders attribute denied claims to a front-end workflow issue.1 Learn how eligibility gaps and undiscovered secondary coverage lead to denied claims and lost reimbursement.
Every denial is a payment at risk. Consider how 17% of Medicare Advantage initial claims are denied on first submission.1 See how stronger revenue cycle processes help more claims go through cleanly the first time and reduce missed filing windows.
Not every denial has to be a write-off. Understand how better tracking and faster follow-up can turn denied claims and missed revenue into money that is collected.
Uncompensated care is often treated as a fixed number. Learn how to connect operational breakdowns to financial impact so you can fix the root causes instead of accepting the outcome.
Denied claims rarely start as denials. They begin earlier with missed eligibility checks, incomplete patient or resident information, or secondary coverage that goes unidentified. These small front-end breakdowns often seem minor, but they create bigger issues downstream.
For Medicare providers, those problems are getting harder to manage. Coverage is more complex, prior authorization requirements are expanding, and Medicare denial rates continue to rise. In fact, 17% of Medicare Advantage initial claims are denied on first submission, and Medicare now reimburses hospitals just 83 cents on the dollar, resulting in more than $100 billion in underpayments annually.
In this 30-minute session, we connect the dots across the revenue cycle and show where revenue is slipping away, why it happens, and how to stop it earlier.
A recent study revealed 78% of revenue cycle leaders attribute denied claims to a front-end workflow issue.1
Learn how eligibility gaps and undiscovered secondary coverage lead to denied claims and lost reimbursement.
Every denial is a payment at risk. Consider how 17% of Medicare Advantage initial claims are denied on first submission.1 See how stronger revenue cycle processes help more claims go through cleanly the first time and reduce missed filing windows.
Not every denial has to be a write-off. Understand how better tracking and faster follow-up can turn denied claims and missed revenue into money that is collected.
The ScriptMed Cloud software solution is an industry leader, serving six of the top ten specialty pharmacies, and 35% of specialty pharmacy patients nationally
Revenue Cycle Expert
Kem is an Innovative Healthcare Leader with a passion for practice transformation through best practices, technology & education. She is the founder and president of Medical Revenue Cycle Specialists, a boutique medical revenue cycle consulting firm, which improves workflow and practice revenues for small to mid-size physician practices, allowing them to focus on patient care.
Over her career of over 20 years, Kem has earned a reputation as a transformational healthcare leader. She is currently also serving as the President of the Hyattsville/Prince George’s County Chapter of the American Academy of Professional Coders (AAPC). In this interview, Kem talks to me about overcoming challenges during the COVID pandemic and her experience as an author
Revenue Cycle Expert
Kem is an Innovative Healthcare Leader with a passion for practice transformation through best practices, technology & education. She is the founder and president of Medical Revenue Cycle Specialists, a boutique medical revenue cycle consulting firm, which improves workflow and practice revenues for small to mid-size physician practices, allowing them to focus on patient care.
Over her career of over 20 years, Kem has earned a reputation as a transformational healthcare leader. She is currently also serving as the President of the Hyattsville/Prince George’s County Chapter of the American Academy of Professional Coders (AAPC). In this interview, Kem talks to me about overcoming challenges during the COVID pandemic and her experience as an author
Revenue Cycle Expert
Kem is an Innovative Healthcare Leader with a passion for practice transformation through best practices, technology & education. She is the founder and president of Medical Revenue Cycle Specialists, a boutique medical revenue cycle consulting firm, which improves workflow and practice revenues for small to mid-size physician practices, allowing them to focus on patient care.
Over her career of over 20 years, Kem has earned a reputation as a transformational healthcare leader. She is currently also serving as the President of the Hyattsville/Prince George’s County Chapter of the American Academy of Professional Coders (AAPC). In this interview, Kem talks to me about overcoming challenges during the COVID pandemic and her experience as an author
See where denied Medicare claims turn into uncompensated care, and what teams are doing differently to reduce lost revenue.
VP, Commercial Strategy, Inovalon
Liz drives revenue cycle strategy, focused on improving access, accuracy, and overall patient and provider experience. She brings over 20 years of experience in technology and product management, with a strong emphasis on aligning solutions to real-world customer needs.
Manager, Product, Inovalon
Jeremy leads efforts to enhance revenue cycle performance, with a focus on Medicare, CMS requirements, and complex data workflows. With more than 17 years in healthcare, he specializes in developing RCM solutions that support more accurate and efficient claims processing.
Sales Engineer, Inovalon
Mark helps healthcare organizations improve financial performance and operational efficiency across the revenue cycle. He brings over 14 years of experience working with providers to address challenges related to reimbursement, quality, and staff productivity.
See where denied Medicare claims turn into uncompensated care, and what teams are doing differently to reduce lost revenue.
Revenue Cycle Expert
Kem is an Innovative Healthcare Leader with a passion for practice transformation through best practices, technology & education. She is the founder and president of Medical Revenue Cycle Specialists, a boutique medical revenue cycle consulting firm, which improves workflow and practice revenues for small to mid-size physician practices, allowing them to focus on patient care.
Over her career of over 20 years, Kem has earned a reputation as a transformational healthcare leader. She is currently also serving as the President of the Hyattsville/Prince George’s County Chapter of the American Academy of Professional Coders (AAPC). In this interview, Kem talks to me about overcoming challenges during the COVID pandemic and her experience as an author
Revenue Cycle Expert
Kem is an Innovative Healthcare Leader with a passion for practice transformation through best practices, technology & education. She is the founder and president of Medical Revenue Cycle Specialists, a boutique medical revenue cycle consulting firm, which improves workflow and practice revenues for small to mid-size physician practices, allowing them to focus on patient care.
Over her career of over 20 years, Kem has earned a reputation as a transformational healthcare leader. She is currently also serving as the President of the Hyattsville/Prince George’s County Chapter of the American Academy of Professional Coders (AAPC). In this interview, Kem talks to me about overcoming challenges during the COVID pandemic and her experience as an author
Revenue Cycle Expert
Kem is an Innovative Healthcare Leader with a passion for practice transformation through best practices, technology & education. She is the founder and president of Medical Revenue Cycle Specialists, a boutique medical revenue cycle consulting firm, which improves workflow and practice revenues for small to mid-size physician practices, allowing them to focus on patient care.
Over her career of over 20 years, Kem has earned a reputation as a transformational healthcare leader. She is currently also serving as the President of the Hyattsville/Prince George’s County Chapter of the American Academy of Professional Coders (AAPC). In this interview, Kem talks to me about overcoming challenges during the COVID pandemic and her experience as an author
Revenue Cycle Expert
Kem is an Innovative Healthcare Leader with a passion for practice transformation through best practices, technology & education. She is the founder and president of Medical Revenue Cycle Specialists, a boutique medical revenue cycle consulting firm, which improves workflow and practice revenues for small to mid-size physician practices, allowing them to focus on patient care.
Over her career of over 20 years, Kem has earned a reputation as a transformational healthcare leader. She is currently also serving as the President of the Hyattsville/Prince George’s County Chapter of the American Academy of Professional Coders (AAPC). In this interview, Kem talks to me about overcoming challenges during the COVID pandemic and her experience as an author
See where denied Medicare claims turn into uncompensated care, and what teams are doing differently to reduce lost revenue.
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Medical Software Specialist
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Medical Software Specialist