{"id":10592,"date":"2020-02-25T13:33:31","date_gmt":"2020-02-25T08:03:31","guid":{"rendered":"https:\/\/www.medicalbillersandcoders.com\/blog\/?p=10592"},"modified":"2026-05-11T11:15:38","modified_gmt":"2026-05-11T11:15:38","slug":"key-role-of-coder-in-denial-management","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/key-role-of-coder-in-denial-management\/","title":{"rendered":"Key Role of Coder in Denial Management"},"content":{"rendered":"

Coders are the backbone of an organization\u2019s fiscal health. Timely coding contributes to timely hospital revenue and cash flow, both of which are essential for a hospital to function. However, coders must be willing to look beyond their traditional roles and examine how they can help ensure the continued financial viability and financial success of the organization.<\/p>\n

We are all undoubtedly familiar with third-party auditors and payers that are scrutinizing our claims more than ever. These oversight contractors are required to identify improper payments and either recoup those payments or prevent payments entirely. Coders typically have access to the complete medical record. Thus, they possess a bird\u2019s eye view of the patient encounter.<\/p>\n

The hospital revenue cycle<\/strong><\/a> spans from the time the patient registers at the facility to the time he or she is discharged and beyond until the facility collects any balances, and the account is closed. This means that coders are in an ideal position to identify areas for process improvement that can help avoid denials.<\/p>\n

Most hospitals address denials retrospectively with very little emphasis on the factors that lead to those denials. As a result, they repeatedly experience the same types of denials.<\/p>\n

The Medicare Fee-for-Service Improper Payment Report includes the following five categories of common denials:<\/strong><\/p>\n