Insurance denials and mechanisms to limit payment are increasing and often overlooked when we talk about health insurance coverage or agreed-upon reimbursement rates.
Insurers' denial of payment was once reserved for a small portion of expensive treatments but is now a common occurrence for ordinary medical care. Denials are exacerbated by payers' use of artificial intelligence, resulting in faster and less reasoned decisions that often lack clear explanations.
One analysis found about 1/3 of inpatient and outpatient claims submitted by providers to commercial payers went unpaid for more than 90 days throughout the first three months of 2023. In some cases, payment can take years!
The underpayment recovery platform for hospitals will go back two years and clients can expect to see the recovered funds in their accounts within 2 months!!
Larry G. Potter
Senior Underpayment Recovery Advisor
Lgpotter33@gmail.com
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