ALPHARETTA, Ga.--(BUSINESS WIRE)--Please replace the release dated February 29, 2016 with the following release containing multiple revisions.
RELAYHEALTH FINANCIAL REPORTS CLAIM DENIAL TRENDS
One of the Industry’s Largest Clearinghouses Provides Insight Based on 262 Million Claims Representing $810 Billion in Provider Revenue
Today RelayHealth Financial disclosed denial rate data for more than 262 million claims processed between October 1, 2015 and February 15, 2016. Of the $810 billion in claims processed using RelayHealth Financial revenue cycle management solutions, just 1.6% have been denied. This denial rate is expressed as a percentage of claim dollars that were initially denied for ICD-impacted denial categories in relation to dollars billed on remitted claims. This rate reflects only the denial categories of Authorization/Pre-Certification, Medical Coding, Medical Necessity, and Untimely Filing. This denial rate has remained unchanged since November and represents approximately $12.9 billion in denied claims since Oct. 1st.
“The good news is that we’re not seeing a marked increase in claim denial rates when it comes to ICD-10, and there is heightened interest in denial management and prevention,” said Marcy Tatsch, Vice President and General Manager, Reimbursement Solutions for RelayHealth Financial. “The bad news is that as many as 1 in 5 claims is still denied or delayed within the normal hospital and provider revenue cycle world, which can mean a dip of as much as 3% in a hospital or health system’s revenue stream2. While it’s important to keep monitoring those KPIs that are monitored on RelayHealth Financial’s Denials Dashboard, healthcare providers should now ramp up their broader denial prevention and management efforts.”
To help providers understand and navigate the challenges surrounding strategic denial prevention and management, RelayHealth Financial now offers an online resource: ReduceMyDenials.com. The site features a number of resources that focus on best practices and operational considerations, with links to case studies, white papers, and a webinar focused on helping providers reduce and manage denials.
Visit RelayHealth Financial at HIMSS16 in the McKesson booth #4002.
Related McKesson RelayHealth Financial News
About RelayHealth Financial
Every day across America, more than 2,400 hospitals and health systems rely on RelayHealth to help them process over 3.3 billion transactions worth $1.8 trillion annually. Our broad array of revenue cycle management solutions use the power of the cloud and big data to help healthcare professionals make better financial decisions for their organizations and patients, right at the point of care. Nobody does more than RelayHealth to bring healthcare connections to life. For more information, visit relayhealthfinancial.com.
McKesson Corporation, currently ranked 11th on the FORTUNE 500, is a healthcare services and information technology company dedicated to making the business of healthcare run better. We partner with payers, hospitals, physician offices, pharmacies, pharmaceutical companies and others across the spectrum of care to build healthier organizations that deliver better care to patients in every setting. McKesson helps its customers improve their financial, operational, and clinical performance with solutions that include pharmaceutical and medical-surgical supply management, healthcare information technology, and business and clinical services. For more information, visit us at www.mckesson.com.
1. “Automated Billing/Payment Process Can Reduce U.S. Health Care Costs without Sacrificing Patient Care.” PNC Financial Services Group, November 2007
2. “Driving the Denials Management Initiative, a Renewed Focus.” The Advisory Board Company, Washington, D.C., web conference, July 2009
Tags: McKesson, McKesson Health Solutions, RelayHealth Financial, Revenue Cycle, Revenue Cycle Management, claims management, patient access, analytics, reimbursement