Initial claims denials are up more than 18% since 2020, according to a Dec. 13 revenue cycle benchmarking report from Kodiak Solutions, formerly Crowe.
Kodiak's revenue cycle analytics software monitors patient financial transactions from more than 1,800 hospitals and 200,000 physicians nationwide, according to the report.
Kodiak's data analysis found that the initial claim denial rate as a percentage of claim value in 2020 was 10.15% and rose to 11.99% through the third quarter of 2023, an 18.1% increase.
"Not only is the overall initial denial rate up for all payers, but each type of initial claim denial — request for information, prior authorization/precertification and medical necessity — is up, too," the report said.
Kodiak found that the surge of initially denied claims is the leading driver of accounts aged more than 90 days.
Aged accounts receivable greater than 90 days as a percentage of claim value for patients with commercial insurance rose to 36% in the third quarter of 2023 compared with 27% in the third quarter of 2020 — a 33% increase.
Aged accounts receivable greater than 90 days as a percentage of claim value for patients with Medicare Advantage plans rose to 27% in the third quarter of 2023 compared with 19% in the third quarter of 2020 — a 47% increase.