In a recent survey conducted by Experian Health, it has been revealed that healthcare providers are experiencing a surge in claim denials, leading to dissatisfaction with payer reimbursements. The survey, known as Experian Health 2024 State of Claims, showed that nearly 3 out of 4 providers have reported an increase in claim denials, marking a 31 percent uptick from the previous study conducted in 2022.
Numbers going in the wrong direction
The increase in claim denials has also been accompanied by a negative trend in provider sentiment, with providers expressing concerns about several key categories such as payer policy changes, time to be reimbursed, and errors in claims. Compared to the 2022 survey, the dissatisfaction levels have grown significantly, indicating a troubling trend in the healthcare industry.
What is causing the rise in claim denials?
Survey respondents identified missing or inaccurate data, authorizations, and incomplete patient information as the top three reasons behind the surge in claim denials. As providers grapple with these challenges, Experian Health has introduced innovative revenue cycle products like Patient Access Curator, aimed at enabling real-time automated discovery of patient data to prevent claim denials.
Going back to the old ways
Despite the pressing need for effective solutions, providers are showing a lack of confidence in their current technology. The survey revealed that only 54 percent of respondents believe their organization's technology is adequate to address revenue cycle management demands, down from 77 percent in 2022. Moreover, the use of automation and AI technology has declined, with providers expressing uncertainty about adopting new technologies to navigate the evolving landscape.
In conclusion, the healthcare industry is facing significant challenges in managing payer reimbursements, with providers under increasing pressure to improve their revenue cycle management processes. As traditional approaches prove to be ineffective, the adoption of proactive strategies and the latest technology is crucial for providers to overcome the complexities of claim denials and ensure financial stability in the long run.