What You Should Know:
– A new Experian Health study reveals a concerning trend in the healthcare industry: claim denials are on the rise, and healthcare providers are increasingly hesitant to embrace technology solutions that could alleviate this burden.
– The Experian Health 2024 State of Claims survey paints a stark picture of the challenges providers face in managing their revenue cycles.
The Growing Claim Denial Crisis
Compared to a similar study conducted in 2022, the 2024 survey shows a significant increase in claim denials, with nearly 3 out of 4 providers reporting a rise in denied claims. This alarming 31% uptick is accompanied by a decrease in confidence in automation and artificial intelligence (AI) solutions, dropping by more than 25%.
Negative Trends Across the Board
Provider sentiment has taken a hit across several key areas, including:
- Increased frequency of payer policy changes
- Longer reimbursement times
- More errors in claims
The Root of the Problem
The top three reasons for claim denials, according to survey respondents, are:
- Missing or inaccurate data (46%)
- Authorizations (36%)
- Inaccurate or incomplete patient information (30%)
Experian Health’s Innovative Solutions
In response to this crisis, Experian Health has launched new revenue cycle products, such as the Patient Access Curator. This tool helps providers leverage real-time automated discovery of patient data to prevent denials.
A Regression in Technology Adoption
Despite the growing need for effective solutions, providers are losing confidence in their current technology. Only 54% believe their organization’s technology is adequate to address revenue cycle challenges, a significant drop from 77% in 2022. The adoption of automation and AI has also decreased, while the number of providers who haven’t even considered these solutions has risen.
“We had hoped to see a decrease in claim denials from our previous survey, but it’s clear these significant challenges are continuing, adding immense pressure on providers to improve their revenue cycle management processes,” said Clarissa Riggins, Chief Product Officer at Experian Health. “This growing crisis is a sign that traditional approaches are no longer enough, and providers should adopt more proactive strategies and the latest technology to navigate this volatility.”