In recent years, healthcare providers have faced increasing challenges with claims denials, a trend that has worsened significantly since 2022. According to Experian Health’s 2024 State of Claims survey, the primary culprits for these denials include prior authorizations and inaccuracies in data submission.
The survey gleaned insights from 210 healthcare staff members responsible for administration in finance, billing, registration, reimbursements, claims, and collections. Participants included chief officers, presidents, vice presidents, directors, and administrators. The results reveal a stark increase in claims denials over the past two years.
- Approximately 40% of respondents report a denial rate of at least 10%, with some experiencing rates as high as 15%. This uptick in denials has led to increased concern about the reliability of reimbursements from payers
- Two-thirds of respondents report longer waits for payments
- 77% of providers feel anxious about the financial implications
Interestingly, despite the clear benefits of leveraging technology to mitigate these issues, there has been a notable retreat from the use of automation and artificial intelligence by provider administrators. From a high of 62% in 2022, only 31% of those polled now employ such technologies. This decline suggests a growing “comfort gap” in utilizing advanced tools despite their potential to streamline operations and reduce errors.
This situation underscores the need for provider organizations to reevaluate their approach and shift towards integrating trusted technological solutions that are designed for the complex landscape of healthcare.