3 Keys to Winning Against Clinical Denials

Community Health Network shares best practices used to reduce denials and streamline denial management efforts across the continuum. Efforts include collaboration among clinical and revenue cycle teams, a focus on front-end prevention and a team approach with clearly defined processes for each role. In 2018 alone, the network recovered $39 million in clinical denials as a result of these efforts.

Learning Objectives:

  1. Discuss structure that fosters collaboration between clinical and revenue cycle teams.

  2. Evaluate techniques, workflows and processes used to streamline denial management efforts.

  3. Review specific steps at the front end, middle and back end used to successfully prevent and overturn denials.

  4. Learn strategies to stay on top of payer trends and policies and improve education among teams.


Tammie Floyd, RN, MSN, CCM, Director Case Management and Clinical Denials Team, Community Health Network
Holly Simpson, MD, CHCQM-PHYADV, Case Management Medical Advisor, Community Health Network