Reducing denials with RCM data: 5 things for hospitals to know

Data that revenue cycle management partners can provide to hospitals is a key piece of the puzzle in reducing payment delays and denials, according to an Oct. 9 blog post by Coronis Health.

Here are the 5 key takeaways from the report:

1. A study by Kodiak RCA looked at data from more than 1,800 hospitals and 200,000 physicians and highlighted increasing initial denial rates, which jumped from 10.15% in 2020 to 11.2% in 2022, with further increases in 2023. This data emphasizes the growing challenge hospitals face in getting paid for services.
2. Solid data provided by RCM partners is helping hospitals build a strong case to identify and address payment roadblocks.The American Hospital Association and the Federation for American Hospitals are actively lobbying with data from the Kodiak report to illustrate the impact of increasing denials on healthcare providers.
3. Payers are continuing to argue that hospitals' service pricing is the primary cause of payment problems. Here, data can be used to assess denial trends and, in turn, help to identify "bad players" within a community or national market.
4. Despite access to extensive data and analytics in the RCM space, many argue there is still a lack of insight into potential care events prevented by payer policies and concurrent denials not captured in analytics.
5. Persistent data-driven advocacy, favorable policy changes and the evolving partnerships with innovative RCM partners are strong indicators that changes in healthcare reimbursement are on the horizon.