Cutting through the clutter: Practical strategies to reduce administrative waste in payer-provider interactions
Administrative costs in healthcare continue to rise, often consuming more resources than direct patient care. Nowhere is this more visible, or more solvable, than within revenue cycle management (RCM). These costs are not just a patient care concern; they strain the workforce and directly impact financial sustainability. Much of the challenge stems from a persistent…
For-profit health systems turn to AI and automation to manage payer denials
Some for-profit health systems are increasingly looking to AI and other automation tools to tackle the worsening problem of payer denial management, as 73% of providers have seen claims denials increase.
Report: Payer requests for information are slowing reimbursement
Payers are increasingly rejecting claims through requests for information (RFI) that in total serve no purpose other than to delay reimbursement, according to “Death by a thousand requests,” a report from consulting firm Kodiak Solutions. RFI claim denial rates as a percentage of total billed charges climbed to 3.82% in 2024 through May, up from…