The revenue cycle moves quickly, and so does its news.
Nearly 17% of in-network claims were denied by ACA marketplace plans in 2021.
Health insurers on the Affordable Care Act (ACA) marketplace denied an average of 16.6% of in-network claims in 2021, according to a brief by Kaiser Family Foundation.
Researchers analyzed data released by CMS on claims denials and appeals for qualified health plans (QHP) offered on HealthCare.gov for the 2021 plan year and found that denial rates ranged significantly from 2% to 49%. The dataset included 162 QHPs that reported receiving at least 1,000 in-network claims and showed data on claims received and denied.
Read more about this study here.
Two out of three patients have never disputed a medical bill.
Patients don't usually contend medical bills, but when they do their chances of getting charges removed or reduced are high, according to a YouGov survey commissioned by revenue cycle firm AKASA.
Over 2,000 Americans were polled between March 9-14, 2022, including 179 adults with employer-sponsored high-deductible health plans, to gauge patient experience with disputed medical bills.
Nearly two-thirds of respondents (64%) reported having never challenged the validity or accuracy of a bill with their physician, hospital, or health insurance company. That figure shot up to 78% for uninsured individuals, while those with high-deductible health plans (45%) and Medicare Advantage (43%) were more likely to contend bills.
Healthcare execs eye workforce and back-office solutions in new AI study.
A new survey on the use of AI in healthcare finds that roughly half of the health systems surveyed are using the technology for back-office operations and workforce issues, and there's a lot of interest in conversational applications.
The survey of 40 leading healthcare executives, conducted by The Health Management Academy, sees growing support for AI "to fill gaps and improve productivity," according to a press release accompanying the report. And that growth is coming fast: Almost 85% of those now using AI for workforce issues expect a moderate to significant increase in one to three years.
Amanda Norris is the Director of Content for HealthLeaders.