How do you resolve a repeated and shooting up problem like claims denials? It’s been a fresher subject for revenue cycle management professionals for years that are only experiencing hotter with the growing pressures of staffing shortages, troubles with staff movement and instructing and developing policies and protocols at the government and payer levels. On […]
Denial rates serve as a barometer for the financial well-being of healthcare organizations. An increase in denials can have wide-ranging negative implications for an organization — impacting everything from accounts receivable to the patient experience. By preventing denials upfront, providers can realize revenue faster, boost staff efficiency and satisfaction, and reduce patient anxiety related to […]
Medical claims denials are on the rise and continue to be a costly problem for health systems. Unfortunately, the vast majority of providers focus their resources on reactive responses, working to appeal denials and recover payments after denials have already occurred. In a Becker’s Healthcare podcast an expert, discussed the problem of rising denials, why […]
The average health system saw 110,000 claim denials due to prior authorization and other factors in 2022, a recent study says. KEY TAKEAWAYS: Revenue cycle leaders are placing denials management at the top of the list of areas to improve for 2023. Denials rose to 11% of all claims last year, up nearly 8% from […]
A recent survey highlighted how payment cuts are affecting denial strategies. Healthcare organizations are on the verge of stepping up their denials management strategies in 2023 as rate cuts are expected to impact revenue. On the delivery side, most practices plan to continue their telehealth operations in the New Year, according to the 2023 Part […]
The billing and collection process in medical offices can be a time-consuming and error-prone process. This can lead to denied claims, uncollected revenue, and frustrated patients. Medical billing companies are looking for ways to optimize this process to improve efficiency, accuracy, and patient satisfaction. One way to optimize the billing and collection process is to […]
In 30 years of running revenue management the usual suspects come up in a Key Performance Indicator (KPI) Dashboard such as Charges, Payments, Adjustments, Net Collection, Gross Collection, Days in AR, AR over 90 Days and Bad Debt. Then you have the breakouts for each category by payer, CPT Code, Location, or ICD Code. There […]
A new analysis shows that claim denial rates for in-network services among Healthcare.gov marketplace payers varied significantly, with some as high as 80%. Claim denial rates varied significantly among Healthcare.gov marketplace payers, with some insurers racking up rates as high as 80 percent, according to a new analysis from Kaiser Family Foundation. Marketplace payers must […]
More than 80% of leading health systems that are using RPA/AI say their primary reason for investing in the technology was improving financial performance, but once the technology was in use, they said efficiency was the top benefit. The reasons that leading health systems initially invest in robotic process automation (RPA) and artificial intelligence (AI) […]
HHS reduced the Medicare appeals backlog by 79 percent during the third quarter of FY 2021, putting the department ahead of schedule to clear the backlog. As of June 30, 2021, the end of the third quarter of FY 2021, HHS had 86,063 pending appeals remaining at the Office of Medicare Hearing and Appeals […]