Market Analysis Reveals Dissatisfaction
with Cash/Cash Flow Amid the Tough Denials Environment
BOCA RATON, Fla., July 23, 2024 /PRNewswire/ -- Amid rising
denial rates and underpayments, 78% of hospital CFOs and revenue
cycle leaders surveyed by Knowtion Health believe hitting cash and
cash flow targets will be even more important to their organization
over the next three years. The findings underscore the importance
of an effective denials management and accounts receivable (A/R)
management strategy in a changing denials landscape.
Knowtion Health's new market study, "Race for Cash: Pivoting
Your Denials Strategy for a New Era," reveals the extent to which
high rates of denials and underpayments, more complex payment
processes, and mounting pressures to contain aging A/R have put
pressure on hospitals' financial performance. Among survey
findings:
- Looming cash need: 25% of those surveyed anticipate
their organization will face significant challenges funding
long-term capital needs.
- CFO scrutiny on denials: Cash and A/R management are
getting a closer look, with 57% of hospitals experiencing denial
rates of 10% or more.
- Low confidence in current denials management
efforts: Nearly 1 in 5 revenue cycle leaders believe their
organization's denials management processes are "not very
effective."
- Rapid technology shift expected: Use of AI in denials
management is minimal (49%) or non-existent (28%) among those
surveyed. In three years, however, the majority of those not
currently using the technology believe adoption in denials
management will be "somewhat likely" (50%) or "very likely"
(31%).
- A deficit of denials expertise is pervasive: 37% of
leaders surveyed say their biggest barrier to improving revenue
recovery from underpayments and denials is insufficient skilled
talent. Clinical denial appeal writing was cited as a high pain
point.
"The sheer volume of denials today versus even three or four
years ago is overwhelming," said one revenue cycle leader. "Payers
are using AI tools to mass downgrade ED levels without reviewing a
single record, denying huge dollars of claims. We are audited ad
nauseam by vendors hired by payers to retract payment on post-pay
reviews. We can't employ enough staff with the appropriate
knowledge and skillsets to effectively fight these
denials."
In "Race for Cash: Pivoting Your Denials Strategy for a New
Era," Knowtion Health outlines the gaps that healthcare revenue
cycle teams are likely to encounter amid growing reimbursement
uncertainty and A/R aging. The analysis also features five
practical takeaways for revenue cycle executives on how to ready
their teams.
"In a turbulent payment environment, healthcare organizations
can't afford to leave dollars at risk," said Jayson Yardley,
CEO of Knowtion Health. "Pressures to improve denials management
and contain aging A/R are mounting, and it's clear a substantial
proportion of hospital leaders don't have confidence in their
organization's denials management strategy. Fortunately, there are
proactive strategies that healthcare finance and revenue cycle
leaders can take to better position their organization for the
future, as outlined in our denials market study."
Knowtion Health serves more than 500 hospitals nationwide and
manages over $4.6 billion annually in
outstanding balance accounts for clients. "At Knowtion Health,
we're dedicated to tipping the balance of power in denials
management back to the hospitals and health systems," Yardley said.
"We look forward to continuing to help providers level the playing
field in insurance claim delays, underpayments, and denials."
Find out more and download the market analysis.
About Knowtion Health
Knowtion Health helps
hospitals and health systems maximize and accelerate revenue
through effective insurance claim resolution and recovery services.
Backed by deep expertise and innovative technologies, Knowtion
Health's team delivers new levels of success with coordination of
benefits and clinical denials, low-balance accounts, complex
claims, and payer audit defense. KnowtionHealth.com—You've Got This
Now.
Contact: Christine
Hanson-Ehlinger, Knowtion Health Marketing, 561-440-1731,
PR@KnowtionHealth.com
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SOURCE Knowtion Health