While providers focus on delivering patient care, the financial processes behind the scenes are increasingly burdened by inefficiencies, rising denial rates and administrative complexity. These ...

The average amounts of a hospital’s denied inpatient and outpatient claims have increased by 12% and 14%, respectively, with greater denial volumes also accompanying an uptick in payer’s audits, ...

Providers spend more than $10 billion annually reviewing and managing denials for claims that should have been paid upon first submission. Medicare Advantage (MA) plans are particularly problematic as ...

Forbes contributors publish independent expert analyses and insights. Dr. Robert Pearl covers the people, tech and business of healthcare. In the late 1970s and early ‘80s, a mysterious illness spread ...