Denial Prevention vs. Denial Management: Are You Focused on the Right One? | Keisha Downes

In this short clip from The RCM Executive Lounge Podcast, Keisha Downes shares a compelling perspective on one of the most critical strategic questions in revenue cycle management today.

With constant policy changes, coding updates, and payer rule variances, most health systems have been pushed into a reactive posture. They manage denials after they occur rather than preventing them at the source.
Keisha's approach starts with the data. What are you actually being denied for? Is it a medical necessity issue? A coding gap? A documentation problem? An education opportunity with the clinician?

Her insight on clinician coding is especially actionable. Clinicians are not coders, yet health systems routinely expect them to select the correct ICD-10 code without the tools to do it accurately. The solution is not placing a coder next to every clinician. It is embedding coding intelligence directly into the clinician's workflow through EMR policy uploads, AI-assisted prompts, and real-time alerts that catch errors before a claim is ever submitted.

Done right, this approach does not just reduce denials. It also improves the patient experience by eliminating unexpected financial surprises that go beyond what insurance covers.

For RCM leaders focused on moving from reactive denial management to proactive denial prevention, this clip offers a practical and immediately applicable framework.

🎧 Watch the full episode of The RCM Executive Lounge Podcast linked in the description.

Learn more about ArceeHQ and our comprehensive AI solutions platform for reducing denials, increasing adoption of patient financing and utilization of financial assistance:
👉 https://arceehq.com?utm_source=podcast&utm_medium=podcast&utm_campaign=episode1

Download the free white paper on the play book for reducing claim denials:
👉https://arceehq.com/claims-denial-management/the-executive-guide-to-reducing-claim-denials-with-agentic-ai?utm_source=podcast&utm_medium=podcast&utm_campaign=episode1

Download the free white paper on the play book for increasing patient financial engagement:
👉https://arceehq.com/patient-financial-engagement-financing-and-assistance/the-financial-engagement-playbook-agentic-ai-strategies-to-boost-collections-with-compassion?utm_source=podcast&utm_medium=podcast&utm_campaign=episode1

Evaluate your ROI of reducing claim denials using the ROI calculator:
👉https://arceehq.com/claims-denial-management/roi-calculator?utm_source=podcast&utm_medium=podcast&utm_campaign=episode1

Evaluate your ROI of increasing patient financial engagement using the ROI calculator:
👉https://arceehq.com/patient-financial-engagement-financing-and-assistance/roi-calculator?utm_source=podcast&utm_medium=podcast&utm_campaign=episode1

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Видео Denial Prevention vs. Denial Management: Are You Focused on the Right One? | Keisha Downes канала The RC Executive Lounge