Claims adjudication cost providers more than $25.7 billion in 2023, and nearly $18 billion of that may have been unnecessary because many disputed claims were ultimately paid after review, according to a major hospital survey reported by
Claims adjudication cost providers more than $25.7 billion in 2023, and nearly $18 billion of that may have been unnecessary because many disputed claims were ultimately paid after review, according to a major hospital survey reported by
A familiar scene plays out in specialty practices every day. Your team submits a clean claim for a service you perform constantly, the EOB comes back, and the payment is nowhere near the charge or what your
An out of network claim lands in your work queue. The case was legitimate, the documentation is solid, the coding is supportable, and the payer still sends a payment that bears little resemblance to the value of
$262 billion in healthcare claim denials each year is not a billing nuisance. It's a revenue control failure, and a large share is avoidable according to this denial management estimate. If you're treating denials as routine back-office
