Over 1150 Total Lots Up For Auction at Three Locations - WI 07/09, NJ Cleansweep 07/10, CA 07/11

Increasing denials, prior authorizations driving providers to drop health plans

por John R. Fischer, Senior Reporter | March 13, 2024
Business Affairs Insurance

According to HFMA and Eliciting Insights, providers should use these challenges as motivation to partner with revenue cycle management vendors to develop more advanced tools that leverage robotic process automation, AI, and advanced analytics that can eliminate tedious manual processes, and with them, errors that often lead to denials in care.

Gundling says that the best ways to reduce prior authorization requirements and avoid denials are:

    stats
    DOTmed text ad

    Ensure critical devices are ready to go

    Keep biomedical devices ready to go, so care teams can be ready to care for patients. GE HealthCare’s ReadySee™ helps overcome frustrations due to lack of network and device visibility, manual troubleshooting, and downtime.

    stats Advertisement

  • Understand the specific insurance policies and guidelines

  • Gather complete patient information

  • Maintain communication channels with the insurance company and patient

  • Leverage technology, automation, and artificial intelligence to streamline repetitive tasks and reduce errors

  • Track requests, status, and needed follow-up. This includes tracking denial metrics to help improve processes.

The 42-page report is based on survey responses from 135 health system chief financial officers and qualitative interviews with CFOs conducted in the first quarter of 2024.

Back to HCB News

You Must Be Logged In To Post A Comment