RelayHealth Financial on Monday released a report showing that of the 262 million ICD-10 claims it processed between October 1, 2015, and February 15 using RelayHealth Financial revenue cycle management systems, only 1.6 percent were denied.
This denial rate has remained unchanged since November and represents approximately $12.9 billion in denied claims since October 1, the vendor said.
“The good news is we’re not seeing a marked increase in claim denial rates, and there is heightened interest in denial management and prevention,” said Marcy Tatsch, vice president and general manager of reimbursement solutions at RelayHealth Financial. “The bad news is as many as one in five claims in the U.S. still is denied or delayed – which can mean a dip of as much as 3 percent in a hospital or health system’s revenue stream.”
It’s important to continue to monitor and examine these key performance indicators, which can be observed on RelayHealth Financial’s Denials Dashboard, the vendor said. Additionally, healthcare provider organizations now should ramp up broader denial prevention and management efforts, the vendor contended.
RelayHealth Financial has unveiled at HIMSS16 a new tool designed to help providers understand and navigate the challenges surrounding strategic denial prevention and management, an online resource at 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.