Insurance denial rates have increased significantly in the post-COVID-19 world, negatively impacting reimbursements. This escalation of denials is causing huge administrative burdens for hospitals, health systems and physician groups.
The demand for staff to work aged insurance and denials has also increased. With labor costs growing across the board for providers and vendors, these competing pressures result in reduced margins and even operating losses for some.
Reducing Denials
There are really only two options for starting to beat the payers at the denials game:
- Build AI in-house via your internal IT team and deploy it with your existing staff. Providers need to be using AI aggressively to automate billing, claims follow-up and the appeals process in order to increase the response times and throughput to match that of the payers who have added significant utilization of AI over the past couple of years.
- Partner with an expert denials resolution vendor that is using similar automation and can add staff and automated throughput to increase your current capacity.
Unfortunately, many healthcare provider teams do not have the internal staff or financial resources to build AI technologies. That leaves choosing and partnering with the right vendor as typically the best solution.
Download your copy of Calming the Claim Denial Riptide, published in the AAHAM Fall Journal, and get the right strategies to help your enterprise reduce denials and recover more cash. Click here to view the article.