Get aggressive when managing denials

Hypertension, mental health disorders, and diabetes lead the list of pre-existing conditions, according to a new report from the Government Accounting Office (GAO).

Although the Affordable Care Act will make it illegal for insurance companies to deny coverage based on pre-existing conditions in 2014, it won't address some of the other inherent management problems associated with denials, says Jeffrey B. Milburn, MBA, CMPE, of the MGMA Healthcare Consulting Group.

When it comes to pre-existing conditions, many of the group insurance plans reimburse, but a subset of patients is at risk for denials or denied access to health insurance.