Productivity for Denials Specialists
Does anyone have any productivity metrics/expectations for your RN denials team? How many appeals do you expect per day, per week, per month and how do you measure productivity? Do you include any other tasks such as calls to payers and how do you measure this activity?
Comments
Hi Patricia,
I log all of my activities and chart reviews. I try to stay within 1-1.5 hours per DRG downgrade appeal if all is straightforward and a reasonable length of stay. Appeals beyond first level usually take about 30 minutes. My productivity isn't closely measured, but my appeal quality is reviewed by my physician advisor. I would think you could evaluate the productivity with the appeal quality. A one or two page appeal shouldn't take more than 1-1.5 hours, but a 6-8 page appeal with a detailed persuasive argument could be much more time consuming. I am evaluated for the quality of my work and the quality of the education I provide the team. I'd be happy to discuss further if helpful for you
I appreciate your response and would love to discuss further. I am first and foremost interested in quality work. I would greatly appreciate it a call of discussion off line if you don't mind. My contact info is:
patricia.fountain@umassmemorial.org
work # 1-774-502-9278