Create a follow-up commitment to investigate and reduce one recurring denial cause.
Root-cause one recurring medical billing denial a denial pattern involving authorization, diagnosis support, modifier edits, eligibility, COB, missing documentation, or patient notice I will select one recurring denial type, review five recent accounts, write a Five Whys chain to name the process cause, test one prevention step on a small batch, and track whether the same denial appears again within three business days. In three days, compare the small batch to the prior pattern and decide whether to adopt, adapt, or abandon the prevention step. Five claims denied for diagnosis not supporting a lab or imaging service. Five claims denied…
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