MedCity News February 26, 2024
The combination of technology and cross-functional collaboration allows providers to address denials and achieve optimal revenue performance.
Work silos—fragmented teams working independently of one another—represent a significant barrier to high-quality communication and collaboration, without which healthcare organizations cannot achieve optimal revenue cycle performance. Denial management is a perfect example.
The impact of silos in denial management
Payers are denying a record number of claims, especially Medicare Advantage plans, costing providers millions in lost revenue potential annually. A 2023 brief by KFF shows an average denial rate of 17% on all in-network claims, 24% for authorization denials, and 37% for medical necessity denials. Another report found that more than 22% of organizations claim to lose half a million dollars annually due...
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