Denials are rising across the board. Between 2023–2024, 60% of medical group leaders reported increases. In fact, payers denied nearly 1 in 5 in-network claims in 2023.
Most denials are preventable. Oftentimes claims are submitted with incomplete information, missing documentation, coding errors, or lack of prior authorization. The challenge is bandwidth — short-staffed (and inexperienced) teams can’t keep up. Nor are they necessarily incented to overcome the payer denial pushback.
Proactive denial management, powered by staff training, RCM partnerships, and AI-enabled tools, ensures claims are worked thoroughly and future denials reduced.
Read the full article to learn more about preventing claim denials, along with other considerations that can affect your revenue cycle and the success of your practice.