In revenue cycle management, which activity primarily addresses denied claims to pursue payment?

• A. Denied claims and pursuing payment adjustments.
• B. Patient eligibility and enrollment.
• C. Coding accuracy.
• D. Budgeting and forecasting.

Answer: (A)

Denial management is the focus here. When a claim is denied, the primary activity is to analyze the denial reason, correct any issues if possible (such as documentation, coding, or eligibility), and resubmit the claim or file an appeal to obtain the payment. This direct work on rejected claims drives actual cash collection and helps reduce accounts receivable days.

Upstream steps like patient eligibility ensure coverage before service but don’t address denials after the fact. Coding accuracy is about preventing denials by getting the coding right from the start, not the post-denial process itself. Budgeting and forecasting are about financial planning, not pursuing payments on denied claims.