Chief Healthcare Executive February 26, 2025
An analysis by Premier Inc. notes that the costs of fighting claims has risen, and there’s an uptick in prior authorization demands from Medicare Advantage plans.
Hospitals and other providers are spending a lot more money in battles over insurers over paying claims, according to a new analysis by Premier Inc.
Health systems, hospitals and post-acute care providers paid more than $25.7 billion in claims adjudication in 2023, up from $19.7 billion the previous year, an increase of 23%.
Most claims that are initially denied are eventually overturned and paid. Premier’s analysis found that nearly 70% of claim denials are reversed. Nearly $18 billion was spent unnecessarily on battles over paying claims in 2023, according to the Premier report released...
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