RelayHealth financial reports claim denial Trends

Feb. 29, 2016

RelayHealth Financial disclosed denial rate data for more than 262 million claims processed between October 1, 2015 and February 15, 2016. Of the $810 billion in claims processed by more than 2,400 hospitals and 630,000 providers using RelayHealth Financial revenue cycle management solutions, just 1.6 percent have been denied. This denial rate has remained unchanged since November and represents approximately $12.9 billion in denied claims since October 1st.

“The good news is that we’re not seeing a marked increase in claim denial rates, and there is heightened interest in denial management and prevention,” said Marcy Tatsch, vice president and general manager of Reimbursement Solutions for RelayHealth Financial. “The bad news is that as many as 1 in 5 claims is still denied or delayed1–which can mean a dip of as much as 3 percent in a hospital or health system’s revenue stream.2 While it’s important to keep monitoring those KPIs that are monitored on RelayHealth Financial’s Denials Dashboard, healthcare providers should now ramp up their broader denial prevention and management efforts.”

To help providers understand and navigate the challenges surrounding strategic denial prevention and management, RelayHealth Financial now offers an online resource: ReduceMyDenials.com. The site features a number of resources that focus on best practices and operational considerations, with links to case studies, white papers, and a webinar focused on helping providers reduce and manage denials.

For more information on RelayHealth Financial’s revenue cycle management solutions, visit their website.

For more information on McKesson Health Solutions, please visit their website.

Reference

  1. “Automated Billing/Payment Process Can Reduce U.S. Health Care Costs without Sacrificing Patient Care.” PNC Financial Services Group, November 2007
  2. “Driving the Denials Management Initiative, a Renewed Focus.” The Advisory Board Company, Washington, D.C., web conference, July 2009

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