2017 RCM Project: Reducing Claim Denials


The 2017 Revenue Cycle Management (RCM): Reducing Claim Denials Project supports Montana Critical Access Hospitals (CAHs) with revenue cycle management by targeting the reduction of insurance claim denials. The focus is to identify and improve processes where claim denials originate (documentation supporting medical necessity, coding, entering patient information, insurance verification, etc.)

A cohort of CAH representatives will work and learn together to identify their most common sources of denials, determine the process that will be targeted for improvement, understand how the process currently works in order to identify the root causes of the denials, generate evidence-based solutions and develop a plan for continuous improvement.


Session Materials & Recorded Webinars

Shared Reports & Tools

Project Timeline

  • February 1, 2018 – Project remeasurement data due
  • April 2018 – Remeasurement report available

Revenue Cycle Management Project Objectives:

  • To identify and develop best practices for reducing the number or total cost of denied claims at Montana CAHs; supported with metrics to track future performance.
  • To provide a cohort-based performance improvement format around a targeted financial/operational indicator to develop statewide tools, processes and shared learning to improve CAH financial performance and to positively impact financial/operational outcomes at both the individual facility and statewide level.
  • To increase Performance Improvement Network (PIN) bi-directional engagement through virtual and in-person opportunities
    • Virtual Networking – virtual network meetings, training & report sharing using a variety of lean/ QI tools
    • In-person regional project workshops (locations determined by participating facility locations)
    • Completed project sharing opportunities via the MT PIN website and a statewide PIN webinar.

Participating CAHs

Broadwater Healthcare – Townsend
Deer Lodge Medical Center – Deer Lodge
Glendive Medical Center – Glendive
Livingston Healthcare – Livingston
Marcus Daly Memorial Hospital – Hamilton
Marias Medical Center – Shelby
Mountainview Medical Center – White Sulphur Springs
Northern Rockies Medical Center – Cut Bank
Roosevelt Medical Center – Culbertson
Roundup Memorial Healthcare – Roundup
Sidney Health Center – Sidney