Texas Health Resources Shifts Denials Strategy to Bulk Payer Patterns
At Becker's 11th Annual Health IT + Digital Health + RCM Conference, Texas Health Resources associate vice president Jamie Williams described a shift away from working insurance denials one claim at a time toward identifying large-scale payer denial patterns and resolving them through bulk appeals. The change followed an 18-month-old rebuild of the system's Epic denials workflow, which gave the revenue cycle team visibility into which actions actually resolve denials. Williams said confirmed patterns are now raised formally through the payer Joint Operating Committee rather than handled quietly by staff. University of Maryland Medical System described a parallel shift at the same panel, using a data "command center" and a payer behavior library to track denial codes like CO-50 and CO-197 and intervene before losses compound.