RevCycle Intelligence reports, “It may take some time to get paid for medical services, suggests a new survey of hospitals, health systems and post-acute care providers.” Almost “15% of medical claims submitted to private payers for reimbursement are initially denied, respondents representing over 500 organizations told Premier Inc. in the survey.”
And “an average of 3.2% of denied claims also included those that were pre-approved through the prior authorization process.” In spite of “the initial claim denial rate, over half of the claims rejected by private payers at first were paid,” Premier Inc. reported, but physicians “said that more initial denials may have been ultimately reimbursed if not for resource constraints that prevented them from pursuing payments through appeals and other means.”
Related Links:
— “Private payers initially deny nearly 15% of medical claims,” Jacqueline LaPointe, Revcycle Intelligence, March 25, 2024