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Our Perspectives


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Steven Silverman


Feb 17, 2022

Do You Have the Concrete Evidence You Need to Reduce Denials?

People who have worked on denials for a while typically discover that they cannot improve their organization’s performance on denials on their own. They must engage with people in other departments to address the root causes of denials across the organization. Wherever you discover denials in the revenue cycle, you will likely need someone else to make a change to eliminate them.

Getting that change to happen can be very difficult. One approach that has been found to work well for getting change to occur is providing concrete evidence of the denials. Concrete. Evidence.

Here is what happens when you provide concrete evidence about denials to others in your organization.

You Need Concrete Evidence to Make an Impact

Finding the source of denials is critical. There is no doubt about that. You need to drill-down into the data to find root causes. But finding the denials is just the first step. It is important to use this information with others in the organization to eliminate the denials from their areas.

Some organizations rely on anecdotal information to identify and communicate denials. However, without concrete evidence of what needs to be fixed, it is often difficult to persuade departments or individuals to change.

Alternatively, sharing specific, quantifiable, detailed denials information in the organization helps others to understand the situation, make a change, and fix the issue. The information enables people to make changes to reduce specific denials. In many organizations, concrete evidence of denials may be all that a department needs to influence their decision to make a change.

That evidence can even be a retrospective analysis that looks at why a situation occurred. You might, for example, identify what led up to a write-off. Pin-point evidence that shines a light down to the level of an individual is the most useful approach.

Concrete evidence also helps organizations to test hypotheses. For example, you might think you have authorization issues with a particular payer. Concrete evidence provides the detail organizations need to put action behind the problem. Concrete data helps you go to the payer and say, ‘here's your issue.’ It gives you the back up to start to make an impact. Concrete evidence can provide the support you need to escalate a denials issue with a payer.

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Evidence of Denials Supports Collaboration

Merely sharing the evidence is not enough to drive action. You must collaborate effectively with others to make change happen. Evidence of denials encourages collaboration with clinical departments and payers. Evidence can change an internal partner’s perspective allowing a better working relationship.

Showing departments exactly the impact denials have to the organization helps people to get on board. Instead of just showing them the denials, you can partner with them and work through the process together.

Evidence Supports Communication

Concrete evidence can also support better communication. If you have it, you can share evidence, such as detailed dashboards, across the organization. This sharing can foster discussion and communication in meetings by highlighting trends and top processes for focus.

Evidence From a Proven Method Empowers You

Organizations that do not have a proven method for quantifying denials have a harder time making change happen. A proven method increases confidence in the evidence. Once your organization uses a method for itself, it becomes easier to prove to others that the approach is useful.

You can show what you have done successfully. When you have those success stories, you are empowered. You are not just describing an idea of what might happen. You can now say, ‘here's our success story from our organization. Let's work on it together.’

Evidence Drives Internal Process Change

The evidence you provide drives internal process changes. You can use it to develop training and education, identifying trends for denials, and improving processes.

When you have evidence, you can show in monthly meetings that what you did really helped drive change.

Evidence Drives Sr. Executive Action

Evidence can also highlight topics for discussion with executives showing where they can have an impact on denials.

Concrete evidence of denials supports conversations with a CFO or other leaders. This provides the foundation you need to draw attention to the denials issue, creating a case for acting.

Repeated reporting of the same denials keeps the issue in front of decision makers at regular meetings. Evidence of denials reduction based on others’ experience helps make the case.

Finance teams can also use denials evidence not just on AR follow up, but for addressing overall revenue cycle and contractual issues.

Evidence Creates Respect

Finally, concrete evidence can improve a working relationship. The evidence can foster a deeper respect for how denials are discovered, which helps to build rapport with other departments.

Where is Your Concrete Evidence?

Alphalytics by Lumedic provides the concrete evidence organizations need to address denials. Organizations from coast-to-coast now use Alphalytics to drill down layer after layer to find the root cause sources of denials. Dashboards and reports provide the concrete evidence that lets them communicate and collaborate across the organization.

To find out how you can get the concrete evidence you need to reduce denials in your organization, register for an Alphalytics demo today, click here.

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