DOTmed March 13, 2024
Cumbersome prior authorization policies and the rising number of denials that result from an inability to meet these requirements has taken a toll on health system operating margins and pushed many to either drop or consider ending their affiliation with health plans, resulting in higher out-of-pocket costs and limiting access to care for patients.
In a new report published by the Healthcare Financial Management Association (HFMA) and health strategy and market research company Eliciting Insights, HFMA Health System CFO Pain Points 2024: Margin Challenges & Opportunities for Vendors, 90% of health systems say denials are the top challenge for their revenue cycle teams and 82% of chief financial officers say that denials have only gone up significantly since pre-pandemic levels.
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