What is the concept of denial in Revenue Cycle Management (RCM)?

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Denial in Revenue Cycle Management (RCM) refers to the rejection of a claim for reimbursement by a payer.

Denials can occur for various reasons such as incorrect patient information, lack of pre-authorization, coding errors, or exceeding the coverage limit.
Analyzing denial trends can help identify areas for improvement in the revenue cycle process.
Effective denial management involves appealing denied claims, correcting errors, and preventing future denials.
Examples of denials include claims denied due to lack of medical necessity, duplicate billing, or incomplete documentation.

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