Becker's Healthcare October 24, 2024
Franklin, Tenn.-based Community Health Systems has seen increasingly aggressive payer behavior on the commercial and Medicare Advantage fronts in recent quarters, creating significant financial headwinds for hospitals, executives said during the company’s Oct. 24 earnings call.
“We are seeing some payers aggressively deny payment for medically necessary services that have been provided for our patients for several quarters now,” CEO Tim Hingtgen said. “In response, we have enhanced our utilization review program and centralized physician advisory services to ensure our patients are placed in the correct care status and that we receive appropriate payment.”
CHS’ physician advisor program has achieved a high rate of reversal on initial payer denials but the rate of denial activity by payers continues to grow...
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