Large Balance Denials, Part 1

Self-Pay Stream

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.