HomeLatest NewsSDAHO EnterprisesEmpowering Healthcare Providers Against Rising Payer Denials

Empowering Healthcare Providers Against Rising Payer Denials

SDAHO Enterprises Endorsed Business Partner CorroHealth recently published an article on Healthcaredive.com. The article entitled “Empowering Healthcare Providers Against Rising Payer Denials” discusses the rising tension between healthcare providers and payers, the increase in denial rates and what that means for provider sustainability and patient care.

Read a snippet of the article below:

In the rapidly evolving landscape of U.S. healthcare, the tug-of-war between payers and providers is continually intensifying, raising the stakes on the strategic maneuvers that shape the industry’s financial and operational dynamics. The crux of the issue lies in the increasingly sophisticated strategies employed by insurance companies to deny claims: a move that ostensibly aims to safeguard their bottom lines, often at the expense of provider sustainability and patient access.

The rise in denial rates is more than a mere statistic; it’s a symptom of a broader systemic challenge that calls for strategic foresight and robust expertise. In this intricate environment, providers face numerous administrative challenges, working to balance clinical decisions with financial sustainability.

Drawn from in-depth proprietary analytics, clinical regulatory expertise, and decades of experience, CorroHealth addresses what is needed to successfully combat payer denial tactics. Broader industry trends, such as the shift towards value-based care and the increasing emphasis on patient-centric models, will continue to disrupt the historic provider business model. CorroHealth’s insights offer a beacon for steering through these turbulent waters. Their strategic recommendations, from optimizing contract negotiations to leveraging data analytics to managing payer denials, to formalizing escalation paths, reflect a comprehensive approach to mitigating the adverse effects of ever-shifting payer denial tactics.

Delving deeper into the anatomy of payer denials reveals a long-term pattern of deliberate complexity designed to wear down provider resilience. By dissecting the layers of denial management, from initial claim submission to final resolution, CorroHealth uncovers pivotal areas where targeted interventions dramatically shift outcomes in favor of healthcare providers. This process involves a granular analysis of denial codes, predictive analytics to pre-empt possible denials, and rigorous training staff to maneuver through the intricate appeals process effectively.

The Full article can be accessed here.
 

About CorroHealth

SDAHO Enterprises’ Endorsed Business Partner CorroHealth is a trusted source on pricing, coding, reimbursement and compliance. The CorroHealth team helps clients do things better, faster, more efficiently, and with the highest levels of compliance across the full clinical revenue cycle.

 The SDAHO Enterprises Endorsed Business Partner program was established to provide innovative and cost-effective solutions for our member hospitals and long-term care facilities across the healthcare continuum. The business partners selected are expected to meet high-quality standards and offer products or services which are designed to assist healthcare facilities avoid costs, recover revenue, reduce operating and capital expenses, improve management and quality, increase productivity, and develop staff resources.

 

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