You find out from billing that a growing number of processed claims are returning as denied. Upon further investigation, you find that the root cause seems to be the inconsistency of checking eligibility of patients. Goal – Develop a solution to reduce the number of denied claims and that utilizes the team more to assist in accomplishing the goal.
Opportunity for Improvement (Problem Statement): .
Who needs to be given opportunity for input?
Decision making process:
Recommended Action Steps: