Over the past year and a half, hospitals and health systems have seen a significant rise in denials, especially for new services such as telehealth. This rise is largely due to new rules and new codes related to the pandemic, the speed with which these new regulations were enacted, and the sheer volume of new services introduced.
The pandemic, and regulations introduced to respond to it, landed a critical blow in one of the industry’s most sensitive and most costly blind-spots: regulatory awareness. Prior to the pandemic, coverage denials cost an average-sized hospital upwards of $240,000 per year. This figure has likely already grown and will likely continue to grow as the healthcare payment and delivery system continues to transform.
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