Eligibility Verification and Securing Preauthorization

The Change Healthcare 2020 Denials Index which is an analysis of 102 million hospital transactions valued at $407 billion in total charges across more than 1,500 U.S. hospitals, reports the average medical claims denials rate to be up by 23% since 2016, topping 11.1% of claims denied upon initial submission through the third quarter of 2020. Half of denials were caused by front-end revenue cycle issues; registration/eligibility, authorization, service not covered. The top denials cause was related to Registration or Eligibility, approaching 27% of denials and remained constant since 2016 followed by missing or invalid Claim Data leading to 17.2% denials. Authorization/Precertification related reasons were found to lead to 11.6%of total denials. It was found that 86% of denials were potentially avoidable; concluding that a lot of revenue loss is occurring that is preventable.

Curemed solutions possess a team with multiple years of experience in medical billing cycle provides you with: