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 B News Predictions Survey conducted in the first two weeks of December.
Asked how they would respond to the reduction to the payment conversion factor, more than half, or 51%, of respondents reported that they will be “more aggressive” in challenging denied claims.
About 46% of survey respondents also said they would increase their collections efforts with payers. One respondent added that “we will be more aggressive about authorizations for Medicare Advantage plans,” according to the survey results.
More drastic measures don’t appear to be on the agenda of most practices. Just 16% of respondents said they will add self-pay services; 15% reported that they would limit staff hours; and 11% said they would be forced to delay the purchase of office equipment or software. Less than 4% of practices said that staff lay-offs are on the table, according to Part B News.
These findings come on the heels of a similar survey by Experian Health that found that the nearly three out of four respondents reported that reducing denials is their highest priority, and 70% said that it is more important than prior to the pandemic.
Additionally, the top three reasons for an increase in claims denials in the Experian Health survey were insufficient data analytics (62%), lack of automation in claims/denials process (61%), and lack of thorough training (46%).