The State of Claims and Denials in 2023
How do you resolve a repeated and shooting up problem like claims denials? It’s been a fresher subject for revenue cycle management professionals for years that are only experiencing hotter with the growing pressures of staffing shortages, troubles with staff movement and instructing and developing policies and protocols at the government and payer levels. On the macro-economic classification, denials play a part mightily to the expanding problem of unpaid care in America, presently calculated at $43 billion a year, and a latest survey of provider organizations established the rate of claims denials growing year-over-year at a 10%-15% clip as a consequence of space created along each step of the patient’s financial journey – from scheduling to access and registration to coding, billing and collections. What’s operating denials? According to those same survey dialogists, the best 5 drivers are authorizations (48%), provider eligibility (42%), code inaccuracies (42%), incorrect modifie