Healthcare’s Dissatisfaction With Payer Reimbursements Continues
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Numbers going in the wrong direction
Coinciding with the increase in claim denials was a negative uptick in provider sentiment across several categories compared to the prior survey in 2022, including:
- 77 percent of providers surveyed say payer policy changes occur with more frequency vs. 67 percent
- 67 percent of providers surveyed say time to be reimbursed is increasing vs. 51 percent
- 55 percent of providers surveyed say errors in claims are increasing vs. 43 percent
What is causing the rise in claim denials?
The top three reasons survey respondents chose are the following:
- Missing or inaccurate data (46%)
- Authorizations (36%)
- Patient information inaccurate/not complete (30%)
As the need for effective solutions becomes more dire,
“We had hoped to see a decrease in claim denials from our previous survey, but it’s clear these significant challenges are continuing, adding immense pressure on providers to improve their revenue cycle management processes,” said
Going back to the old ways
Unfortunately, providers are lacking confidence in their current solutions and unsure of new technology. Just 54 percent of survey respondents say their organization’s technology is sufficient to address existing revenue cycle management demands compared to 77 percent in 2022. Providers that use some form of automation and/or AI technology also decreased, from 62 percent in 2022 to 31 percent in 2024, while providers that have not considered or evaluated automation technology increased from 5 percent to 28 percent. Why? It seems the comfort gap has plummeted with those that are very or extremely confident in understanding automation, machine learning and AI at only 28 percent compared to 68 percent two years ago.
To access the free State of Claims report, go here. The survey was conducted among 210 healthcare staff responsible for administration in finance, billing, registration, reimbursements, claims and collections. Participants include chief officers, presidents, vice presidents, directors and administrators.
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Source: Experian