Denial Management Archives - Page 7 of 8

Cost Of Denials Saw 67% Increase In 2022

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 […]

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Three KPIs that Create an Impact on Your Revenue

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 […]

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Claim Denial Rates as High as 80% for In-Network Services

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 […]

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The Leaders Say Efficiency, Not Finances, Is Top Rev Cycle Rpa/ai Benefit

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) […]

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HHS Removes 79% of Medicare Appeals Backlog, On Track for FY 2022

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 […]

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Over Third of Hospital Execs Report Claim Denial Rates Nearing 10%

Average claim denial rates are between 6% and 13%, but some hospitals are nearing a “danger zone” after COVID-19, a survey shows. Hospital claim denial rates are at an all-time high, signaling a need for better claims denial management, a recent survey from Harmony Healthcare reveals. The healthcare industry has seen a 20 percent increase […]

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Denials Management Versus Denials Avoidance: CDI Can Capitalize

Typical CDI programs are intended to drive reimbursement through diagnosis securement, contributing to improved case mix index. The COVID-19 pandemic is placing monumental financial stressors upon hospitals, with added costs to treat patients with high acuity and long length of stays, coupled with significant revenue loss associated with postponement of more profitable elective surgeries, […]

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September 22, 2020
Blog, Medical Coding
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2020 Coding Guide: Get Paid What You’re Owed

There’s nothing more frustrating than rendering a service and not being paid. Sometimes the problem comes down to a single code. Nuanced coding rules are difficult to understand, and physicians aren’t taught this information in medical school. Still, health care is a business. As business owners, physicians need to know how they’re paid, including […]

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Maximizing AR Collections in HME

Revenue cycle management encompasses everything related to the order-to-cash process. For success in revenue cycle management, constant and vigilant oversight of the key processes is needed. With that oversight, continuous process improvement can help you maximize profitability. Here are some areas to focus on to improve receivable collections. Check Your Front End No matter how […]

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Artificial Intelligence: The Benefits to Revenue Cycle Management

Artificial intelligence (AI) is a concept that has moved very quickly from the realm of science fiction into real and practical utility in a number of different industries—including healthcare. One of the most effective applications for AI-powered tools is in the field of revenue cycle management. Sophisticated AI technologies can sift through vast amounts of […]

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Tag: Denial Management

Cost Of Denials Saw 67% Increase In 2022

Three KPIs that Create an Impact on Your Revenue

Claim Denial Rates as High as 80% for In-Network Services

The Leaders Say Efficiency, Not Finances, Is Top Rev Cycle Rpa/ai Benefit

HHS Removes 79% of Medicare Appeals Backlog, On Track for FY 2022

Over Third of Hospital Execs Report Claim Denial Rates Nearing 10%

Denials Management Versus Denials Avoidance: CDI Can Capitalize

2020 Coding Guide: Get Paid What You’re Owed

Maximizing AR Collections in HME

Artificial Intelligence: The Benefits to Revenue Cycle Management

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