HHS confirms what all hospital revenue cycle leaders have known for years, the inappropriate denials of services and payment by Medicare Advantage Organizations is widespread and persistent.
It's time for health systems and hospitals to move past these three all-too-common business tactics that have remained constant, despite the ever-changing payer landscape and the mounting pressure for providers to lower costs and provide a more seamless payments experience.
The impact of insurance claim denials for healthcare providers in 2021, and how providers' own historical payments data and machine learning provide solutions for both denials prevention and appeals prioritization.
Unless your hospital or health system's denial rate is 0% you're missing earned revenue. Denials management is more than clean claim rate and prevention. How you prioritize insurance denials has a powerful impact on cash flow and revenue. Predictive analytics can tell you which denials your teams should work, in what order, to get the best payment outcomes.
We're at a tipping point where healthcare providers will *have* to implement automation and AI into the revenue cycle. Not only to recover more dollars but also to keep up with the growing (& massive) administrative burden that is persistent in healthcare payments.
Normalized and organized data is a gap in healthcare analytics, even in claim denials management. This is why Sift Healthcare is proud to introduce our Denials Dashboards. Sift scrubs and maps your 835 and 837 data to build a single, normalized data set. This data is organized in an intuitive interface that offers you a new level of oversight for the revenue cycle.