Denial rates have soared to unprecedented levels, transforming what was once a back-office nuisance into a boardroom-level issue for health systems. At Becker’s 13th Annual CEO + CFO Roundtable, two ...
Insurance claim denials have risen 16% from 2018 to 2024, affecting access to essential medications like insulin and albuterol. Denials often result from formulary exclusions, step therapy, and ...
Boris Vabson ([email protected]), Harvard University, Boston, Massachusetts. Andrew L. Hicks, Harvard University. Michael E. Chernew, Harvard University. Policy makers have been paying increasing ...
For years, many healthcare executives treated claim denials as a back-office irritation—a revenue problem to be delegated, not a strategic one to be solved. That era is over. Denials have quietly ...
AI advances in the last few years are changing this. LLMs have made it possible to parse through unstructured information in minutes. Combined with human expertise, it opens the door to working a much ...
Prescription denial rates from private insurers grew from 18.3% in 2016 to 22.9% in 2023 — a 25% increase, according to a July 18 article from The New York Times. Healthcare analytics company Komodo ...
The rejections of prescription drug coverage among private health insurers in the U.S. have jumped 25% from 2016 to 2023, The New York Times reported, citing an analysis of over four billion claims ...
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