Denial Rates Archives

August 16, 2024
Blog, Medical Billing, Medicare Advantage, Prior Authorization
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Medicare Advantage Prior Authorization Denials on the Rise

Surge in MA Prior Authorization Denials: New Study Reveals A new study highlights significant variation among Medicare Advantage plans regarding the number of determinations made and the frequency of denials. Notably, MA Prior Authorization Denials surged between 2021 and 2022, according to a recent analysis from health policy research. Researchers examined data from the Centers […]

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Boosting Staff Efficiency: Four Tactics to Outsmart Denials

Denials within the realm of healthcare persist as a perpetual and escalating issue. By 2022, denials constituted over 11% of claims, posing a significant threat if left unaddressed, as they can severely compromise an institution’s financial well-being and prospects. The combination of outdated technology and manual processes exacerbates the burden on staff, time, and finances […]

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August 16, 2023
Blog, Medical Billing
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8 Medical Billing Tips for Practitioners

Whether you’re a primary care doctor, a specialized medical professional, or an integrative health provider, the intricate landscape of insurance billing frequently presents not just an administrative inconvenience, but, if not managed effectively, it can also hinder the growth of your practice and revenue stream. Recent data reveals that the rate of claim denials stands […]

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OIG Report Finds High Rates Of Prior Authorization Denials In Medicaid Managed Care

In 2019, the Office of the Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) found that one in every eight prior authorization requests was denied by Medicaid managed care organizations. Dive Brief: A recent report by the HHS’ Office of the Inspector General suggests that due to high rates of […]

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Revenue Cycle Management, Reimbursement, Bundled Payments, CDI, Payment models, MIPS, Value Based care, Healthcare Claims, A/R Days, Denial rates, Healthcare Payment, CMS, ACO, Denial Management, Denial Prevention, Health Systems, Account Receivables, Patient Interactions

March 29, 2019
Blog
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How the Revenue Cycle Will Need to Adapt to Value-Based Reimbursement

Value based payment models are undoubtedly the future of health care. The number of commercial and governmental ACO contracts alone increased by an average of 63% annually from Q1 2011 to Q1 2018, according to a Muhlestein et al. analysis of Leavitt Partners’ data. Though commercial payers have been slower to adopt other models that […]

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January 25, 2019
Blog
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Are You Neglecting Charge Capture?

Despite calling it “essential,” many healthcare leadership teams discuss charge capture once a month or less. Despite its importance, charge capture doesn’t get the attention that it deserves, according to a survey of revenue cycle leaders. Although 78% of respondents characterize charge capture as “essential” to their organization’s success, leadership teams at 40% of organizations […]

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Tag: Denial Rates

Medicare Advantage Prior Authorization Denials on the Rise

Boosting Staff Efficiency: Four Tactics to Outsmart Denials

8 Medical Billing Tips for Practitioners

OIG Report Finds High Rates Of Prior Authorization Denials In Medicaid Managed Care

How the Revenue Cycle Will Need to Adapt to Value-Based Reimbursement

Are You Neglecting Charge Capture?

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