News: Denials management reported as most time-consuming to revenue cycle leaders, survey says

CDI Strategies - Volume 17, Issue 17

Revenue cycle leaders reported denials management as their most time-consuming revenue cycle task, followed by prior authorizations, according to a new survey released by AKASA. From a list of 15 different revenue cycle tasks, respondents selected denials management 76% of the time, and prior authorization 60% of the time. This data correlates with multiple other studies showing a growing concern about denials as pressure increases for revenue cycle leaders to increase their bottom lines, HealthLeaders reported.

The five most-selected revenue cycle tasks in the survey were:

  • Denials management (76%)
  • Prior authorization (60%)
  • Insurance follow-up (58.6%)
  • Eligibility and medical necessity checks (26.6%)
  • Patient cost estimation and price transparency requirements (26.4%)

The need to establish a streamlined denials management strategy continues to grow as denial rates keep increasing. A robust denials management process plays a key part in reducing complexity and staff workload and avoiding reimbursement delays for healthcare organizations. Prior authorizations coming in second place also fits this trend, as they greatly impact denials.

“When thinking about the biggest bang for your buck as a revenue cycle leader, few things are as effective as focusing on denials management,” said Amy Raymond, VP of revenue cycle operations at AKASA, in a statement shared with HealthLeaders. “But it’s important to avoid the common mistake of only focusing on working denials, and instead address the root causes.”

Editor’s note: To read HealthLeaders’ coverage of this story, click here. To access the AKASA survey results, click here. To listen to a recent episode of the ACDIS Podcast focused on clinical validation denials, click here.

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Denials & Appeals, News