News: Nearly half of providers have seen denial rates increase in 2023, survey shows

CDI Strategies - Volume 17, Issue 48

Nearly 50% of providers have seen an overall increase in their denials rate compared to the previous year, according to a recent survey commissioned by AKASA. Another 27% said they saw no change, and 26% reported a decrease from 2022 to 2023. Survey respondents also ranked the common reasons for initial payer denials, putting errors in patient access and registration at the top, followed by medical necessity and incorrect patient information, HealthLeaders reported.

The survey used responses from more than 350 chief financial officers and revenue cycle leaders at United States hospitals and health systems using the Healthcare Financial Management Association’s Pulse Survey program. The top five reasons, in order, were as follows:

  • Errors in patient access/registration
  • Lack of documentation to support medical necessity
  • Missing or incorrect patient information
  • Physician documentation issues
  • Utilization management

Other reasons mentioned included coding errors, duplicate claims, and untimely filing of claims.

“This new data confirms what we all know: Issues at the front-end trickle down into the entire reimbursement process. When your patient access operations run smoothly, you’re setting your downstream workflows and teams up for success,” said Amy Raymond, senior vice president of revenue cycle operations and deployments at AKASA, in a report on the survey findings. “If you want to improve your overall claims processing and revenue capture, you need to address challenges holistically across the entire revenue cycle.”

Editor’s note: To read HealthLeaders’ coverage of this story, click here. To access the AKASA survey report, click here.

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Denials & Appeals, News