RCM Challenges: Clinical Documentation Improvement and Utilization Management
Podcast
Matthew Bridge & Erica Franko
April 21, 2023
In the healthcare sector, it is becoming increasingly challenging for patients to receive insurance coverage for their services; payor denials are increasing. Oftentimes, insurance companies are deciding that certain services are not “medically necessary,” making it more difficult for patients to receive access to the care they need. In fact, in 2021, almost 17 percent of in-network healthcare claims were denied—that’s almost one in every five! And combatting an insurance denial is an extreme headache, so healthcare workers and patients don’t always fight back for coverage.
Why is there such a high number of payor denials and how can healthcare companies and patients combat this?
On today’s episode of the RCMchat podcast by AGS Health, host Michelle Dawn Mooney speaks with Matthew Bridge, SVP, RCM Service Line and Erica Franko, SVP of Customer Success, both of AGS Health, to discuss payor denial management in healthcare.
Mooney, Bridge, and Franko also discussed…
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Matthew Bridge
Erica Franko
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