The top 8 reasons for initial payer denials

Errors in patient access, such as eligibility or missing prior authorization, is the top reason for initial payer denials, according to an Oct. 17 report from Akasa, a revenue cycle firm that uses artificial intelligence.  

Advertisement

Akasa surveyed a survey of more than 350 CFOs and revenue cycle leaders at hospitals and health systems through the Healthcare Financial Management Association’s Pulse Survey program. 

Here are the eight most common reasons for initial payer denials, according to the survey: 

1. Errors in patient access/registration

2. Lack of documentation to support medical necessity 

3. Missing or incorrect patient information 

4. Physician documentation issues 

5. Utilization management 

6. Coding errors 

7. Duplicate claims 

8. Untimely filing 

At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.

Download Whitepaper

The cost-saving opportunity most health systems overlook

Many hospitals and health systems scrutinize staffing, service lines, and payer contracts for savings. Fewer look at one of their largest assets: real estate.…

Advertisement

Next Up in Financial Management

Advertisement

Comments are closed.