Fierce Healthcare March 22, 2024
More than 100 provider organizations want the Centers for Medicare & Medicaid Services (CMS) to take a tougher stance on Medicare Advantage (MA) plans’ practices following an industry survey estimating billions per year are spent fighting claims denials.
Providers spent nearly $20 billion in 2022 pursuing delays and denials across all payer types, yet those efforts are substantially more costly on average when dealing with private plans, Premier, a group purchasing organization, wrote in a recent blog post on the new data.
Just over half of the total comes from denied claims that are eventually paid out, meaning that about $10.6 billion is “wasted arguing over claims that should have been paid at the time of submission,” Premier wrote.
Premier...
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