According to the AMA’s health insurer report card, denial rates of claims for major private payers ranged between 0.54% and 2.64%. At the same time, denial rates for Medicare stood at close to 5%. Although the percentage does not sound like too much, given the fact that billions of dollars are claimed each year, the figures for denied claims suddenly assumes gigantic proportions.
Globally, medical practices are facing tough financial times. The growing population coupled with the rise in new diseases is taking its toll on the healthcare system. Healthcare claims are coming under intense scrutiny, and the ever-increasing paperwork and frequently changing laws ensure compliance issues being faced by a medical practice. One of the critical challenges facing medical practices is claims denial.