Payers initially denied $262B in claims last year — 3 key insights

Claims data from Change Healthcare shows payers denied approximately 9 percent of the $3 trillion in healthcare claims submitted in 2016.

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Here’s what you should know:

1. Change believes approximately $262 billion in claims were initially denied. Change calculated the data under the assumption 63 percent would be successfully appealed with a 29 percent average reimbursement rate.

2. Change Healthcare believes advanced analytical products can reverse this trend.

3. Change’s Senior Vice President and General Manager Marcy Tatsch said in a release, “Eye-opening insights like these are only possible with advanced analytics and revenue cycle tools that let you identify the root causes of denials, and implement and automate practices that prevent them.”

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