To fully embrace this strategy, Carlson offers three pieces of advice: Establish a Strong Denials Management Process. Create a framework not only for addressing denials, she says, but also ...

Once you've reviewed the notice and are prepared to appeal, you can begin the Reconsideration process. Reconsideration is the first step in appealing a Social Security benefits denial. During this ...

Will your care be denied? Medicare Advantage insurers use prior authorization to manage utilization and lower costs. How to compare plans during open enrollment.

Journal Editorial Report: The week's best and worst from Kim Strassel, Kyle Peterson, and Dan Henninger. Photo: J. Scott Applewhite/AP/Angela Weiss/AFP/Getty Images/Martin Schutt/AP As Democrats ...

When I breathe (okay), you breathe,” hip-hop artist Doechii says in her song “Denial Is A River ... no time to process/But we ain't got time to stop, the charts need us (And they do).” ...

In the high-stakes world of healthcare revenue cycle management, few issues cast as long a shadow as claim denials. For revenue cycle leaders, the challenge of denials is both urgent and complex ...

If patients die as a consequence of utilization management, whether it comes in the form of requiring a step therapy or prior authorization, or outright denial there is little impact for the insurer.

The appeals process often takes several months or longer. Cohen was not criminally charged. He changed SAC Capital's name to Point72 Asset Management in 2014, and is now worth $21.3 billion ...

Providers can ask insurers to reevaluate claim denials by submitting an appeal letter, but drafting these letters is a time-consuming and expensive process that doesn't guarantee a different outcome.