When a hospital does everything right—notifies the correct payer on time, secures authorization, and submits full clinical documentation—and the claim is still denied, the root cause becomes much harder to pinpoint.
This session explores how subjective decision-making on both the provider and payer side is the biggest obstacle to preventing clinical denials, and how analyzing seven key data points within your EPIC instance can help.
By the end of this session, you’ll be able to:
- Distinguish between procedural and clinically subjective denial root causes and why each requires a different prevention approach
- Recognize how subjective decision-making on both the provider and payer side contributes to clinical denials
- Identify and analyze seven key EPIC data points to trend denial patterns and strengthen clinical denial prevention efforts
