Published: 05 March 2024
U.S. healthcare providers face mounting operational costs and revenue risk due to preventable claims denials. Healthcare CIOs must evolve their revenue cycle technology with predictive analytics and hyperautomation to improve their denials success rate.
Healthcare delivery organizations (HDOs) rework close to one in four claims (23%) submitted to payers, which increases the operational cost of managing denials and financial risk and adversely impacts profitability.
HDOs write off millions of dollars in uncompensated care due to payer claims denials. HDO CIOs struggle to find an effective IT solution for gaining visibility into their payers’ denials trends.
HDO CIOs often conflate the concepts of denials management and denials prevention, leading to suboptimal financial performance. Revenue cycle leaders rely mainly on standardized denial reports and lack descriptive and predictive analytics to proactively address denials or tackle underlying
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