One-third of US hospitals' average denial rates are in 'danger zone,' survey finds

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Thirty-three percent of hospital executives said their organization's average rate of insurance claims that are denied is in the "danger zone," meaning it is more than 10 percent, according to survey results released June 1 by consulting firm Harmony Healthcare.

The firm surveyed 131 hospital executives via LinkedIn between April 27 and May 20.

Below are the survey's findings on American hospitals' average denial rates.

  • Thirty-three percent of hospital executives said their average denial rates were more than 10 percent.

  • Sixteen percent of hospital executives said their average denial rates were between 8 percent and 10 percent.

  • Twenty percent of hospital executives said their average denial rates were between 5 percent and 7 percent.

  • Thirty-one percent of hospital executives said their average denial rates were less than 5 percent.

Below are four key concerns hospital executives have regarding denials, followed by the percentage of respondents who listed them as their top concern.

  • Coding (32 percent)

  • Medical necessity for acute inpatient stays (30 percent)

  • Front-end processes (20 percent)

  • Clinical validation denials (18 percent)

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