Tackling a new denials management hurdle

With all of the changes in health insurance products today, eligibility and benefit determination are more important than ever. Your staff's ability to make accurate assessments regarding eligibility and benefits is critical to reducing denials.

The following are merely a few of the many needles in the ever-growing haystack:

·        New products offer restricted networks that exclude providers or place them in a higher out-of-pocket costs category;

·        Consumer-driven health plans mean higher out-of-pocket costs to the patient;

·        Consumers seeking individual policies or some kind of "lite" product exclude many benefits or severely limit reimbursement; and

·        Employers are switching plans at an increasing rate, creating more changes to eligibility

About the Author

Reed Tinsley CPA

This article is written by Reed Tinsley, a Houston, TX-based CPA with over 30 years of experience advising physicians and medical practices across Texas and the United States. Reed holds certifications as a Certified Valuation Analyst (CVA), Certified Healthcare Business Consultant (CHBC), and Certified Financial Planner (CFP), specializing exclusively in the healthcare sector. He is a published author, nationally recognized speaker, and trusted advisor to physicians on accounting & tax, practice management, and financial planning. Schedule a Free Consultation.