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denials


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publication date

Revenue Cycle
How Health Insurers Have Made Appealing Denials So Complicated
ProPublica | September 19, 2023
Health insurers reject millions of claims for treatment every year in America. Corporate insiders, recordings, and internal emails expose the...
Revenue Cycle
2024 CPT Code Set Released: 5 Key Takeaways
Amanda Norris | September 13, 2023
There are over 300 changes you need to know.
Revenue Cycle
First Wave of UHC Prior Auth Cuts Begin, But Will it Matter?
Amanda Norris | September 05, 2023
In an effort to soften the payer/provider relationship, many large health insurers are rolling back on prior authorizations.
Revenue Cycle
Cigna Sued for Allegedly Using Algorithm to Deny Claims
Jay Asser | July 27, 2023
The health insurer's PXDX system rejected coverage for "hundreds or thousands [of claims] at a time," the lawsuit states.
Payer
Medicaid Managed Care Has High Rates of Prior Authorization Denials
Jay Asser | July 21, 2023
A report by the Office of Inspector General (OIG) finds Medicaid managed care members may not be receiving all medically...
Revenue Cycle
Experts Weigh in on The Future of Rev Cycle Payer Audits
Amanda Norris | July 11, 2023
Payer scrutiny won't be letting up anytime soon, in fact, expect it to intensify.
Payer
How Often Do Health Insurers Say No to Patients? No One Knows.
ProPublica | June 28, 2023
Insurers' denial rates ? a critical measure of how reliably they pay for customers' care ? remain mostly secret to...
Revenue Cycle
Most-Read Revenue Cycle Articles in Q2 2023
Healthleaders | June 27, 2023
Check out the most-read revenue cycle articles from the past quarter.
Payer
How Prior Authorization in Medicare Advantage is Harming Everyone
Jay Asser | June 07, 2023
Even for insurers, the administrative process in the private program has drawbacks that may not be worth the cost savings.
Revenue Cycle
Perspective: Denials of Health Insurance Claims Are Rising — And Getting Weirder
KFF Health News | May 30, 2023
Denials have become another predictable, miserable part of the patient experience.
Revenue Cycle
Are Commercial Payers to Blame for Majority of Rev Cycle Claim Denials, Payment Delays?
Amanda Norris | May 25, 2023
One study says yes.
Revenue Cycle
Leaders Agree, The Revenue Cycle Needs More Denials Management Expertise
Amanda Norris | May 23, 2023
Hundreds of leaders were asked which rev cycle tasks require the most subject matter expertise.
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