Insurance Billing Problems Continue

In the 1970s, my father, a family practice physician, used to complain about insurance denials. It is now 50 years later and we are still complaining.

From Revcycle Intelligence:

It may take some time to get paid for medical services, suggests a new survey of hospitals, health systems and post-acute care providers.

Nearly 15 percent of medical claims submitted to private payers for reimbursement are initially denied, respondents representing over 500 organizations told Premier Inc. in the survey. An average of 3.2 percent of denied claims also included those that were pre-approved through the prior authorization process.

Despite the initial claim denial rate, over half of the claims rejected by private payers at first were paid to providers, Premier Inc. reported. However, healthcare providers 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. (more…)


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