Large Balance Denials, Part 1

A denial, according to HealthInsurance.org, “is the refusal of an insurance company or carrier to honor a request by an individual, or his or her provider, to pay for healthcare services obtained from a healthcare professional." According to Becker’s & Conifer Health Solutions, “an estimated $262 billion of the $3 trillion in claims submitted by hospitals in 2016 were initially denied, representing an average of $4.9 million in potential losses per hospital, according to a 2017 study of more than 3 billion hospital transactions. In part one of a two-part series our hosts Jeff Johnson, Lisa Kirk and Hayden Reece discuss Large Balance Denials with Michael Jacobson who is the Director of Reimbursement and Recovery at Providence Health & Services, and Justin Murphy who is a Compliance Attorney of Professional Credit.

What is Self-Pay Stream?

Self-Pay Stream was developed to address the state of transformation that healthcare is experiencing in terms of financial responsibility. The increase in patient financial responsibility is turning patients into healthcare consumers and changing the way they pursue medical care. This podcast will focus on the new challenges being faced by healthcare organizations in this self-pay environment; from maintaining patient loyalty to optimizing recovery, we will bring together industry experts and cutting-edge data and behavioral science to provide the insights needed to stay competitive in this new evolution of patient care.