News: Commercial denials the top threat to revenue cycles, survey says

A new survey from the Healthcare Financial Management Association (HFMA) reveals the top threats facing revenue cycle leaders, according to HealthLeaders.

The survey was fielded to 106 revenue cycle leaders across the United States. All participants were of a director level whose job functions span from revenue integrity, to administration/operations, to patient financial services.

Here are the main results of the survey (only the top three answers are shown):

• Which of the following is the greatest threat to your organization’s revenue cycle?
  
  • Volume of denials from commercial insurers (48.2%)
  • Declining reimbursement rates (21.6%)
  • Prior authorization issues (14.4%)
• Which of the following is your biggest barrier to improving revenue recovery from denials/underpayment?
  
  • Difficulty prioritizing which denials are worked and when based on revenue benefit (37.6%)
  • Technology gaps in identifying documentation and coding errors (26.4%)
  • Not enough clinical support (17.6%)
• Overall, how would you describe the volume of payer requests for information received over the past year?
  
  • Significantly higher than one year ago (50.0%)
  • Slightly higher than one year ago (36.9%)
  • Same as one year ago (12.3%)
• Looking ahead to the next three years, how do you expect overall demand for clinician support (i.e. appeal writing, medical necessity verification, utilization review, etc.) in your denials management strategy to change?
  
  • The demand will increase significantly (47.4%)
  • The demand will increase slightly (41.2%)
  • The demand will stay the same (7.0%)

Editor’s note: To read the HealthLeaders coverage, click here. To read the HFMA survey, click here.