Healthcare providers must put strategies to pursue each denied claim and establish a workflow that categorizes each claim by reasons for the denial, including complex clinical denials and low-dollar claims. Historical data points on the rate of success by payer and denial reasons will help you create a customized denial appeal process for the institution's type of services and the payers they deal with often. Learning from past denial appeals will help you create a better process for appealing similar claims. Maintaining a database of successful requests by payer and denial reason will help you craft an effective denial appeals process, saving your resources and time in the future.

Join for free to read