A denial-free revenue cycle is something every provider strives for but seems nearly impossible. The industry average denial rate is above 10% and going up. Revenue cycle specialists see a multitude of reasons for claim denials. Here are a few … Read More
Denial Management
5 Reasons Providers Are Seeing Increased Claim Denials
Providers have reported a surge in claim denials and reimbursement delays. According to a study by the American Hospital Association (AHA), 91% of interviewed providers indicate experiencing an increase in denials. Over half (51%) of those providers deemed the increase … Read More
Real-Time Data in Revenue Cycle Management
The healthcare industry must emphasize the importance of minimizing the often unnecessary cost burden associated with reworking of claims due to denials. This can be accomplished by identifying possible claim denials and correcting them before submission. The key to improving … Read More
How to Improve COVID-19 Related Claim Denial Rates
Payers denying healthcare insurance claims is something we all are very familiar with. Whether the claims are denied for missing information, incorrect medical coding, or anything in between, 9% of claims are initially denied, on average. The national pandemic has … Read More
Measuring RCM Performance – The Concept of Clean Claim Rate
Key Performance Indicators (KPIs) are used to measure how an organization or department is performing. Companies often evaluate and analyze their business processes against industry standards to see if there is room for improvement. With the help of industry leaders, … Read More
Need for Management of Complex Denials
Improved medical claim management has been a necessity in the healthcare industry for some time. According to an article in Becker’s Hospital Review, a study showed that 62% of the healthcare executives interviewed noted declining reimbursements to be the most … Read More
Artificial Intelligence in Revenue Cycle Management
What is Artificial Intelligence? Artificial Intelligence (AI) is defined as computers imitating “intellectual processes characteristic of humans, such as the ability to reason, discover meaning, generalize, or learn from past experience” with the ability to achieve goals. AI in healthcare … Read More