Navigating Healthcare's Financial Storm: StafGo Health's Strategic Approach to Claim Denials

In the face of formidable challenges, healthcare organizations find themselves at a crossroads, grappling with issues such as wage inflation, rising costs, and the pervasive uncertainties brought on by the pandemic. This critical juncture has thrust unprecedented pressure on financial stability, particularly as unresolved claims denials result in an annual average loss of $5 million for hospitals—equivalent to 5 percent of net patient revenue.

Understanding the Urgency: Rising Denial Rates

At StafGo Health, we recognize the urgency of this situation. Denial rates have surged, escalating by over 20 percent in the last five years, with the average denial rate now surpassing 10 percent. A recent Medical Group Management Association (MGMA) Stat poll has shed light on the challenges faced by practices, reporting a significant 17 percent increase in denials. Shockingly, industry averages reveal that nearly 20 percent of all claims face denial, and up to 60 percent of returned claims are left unresubmitted. The financial impact escalates further, with reworking or appealing denials costing an average of $25 per claim for practices and an astonishing $181 per claim for hospitals.

Amidst these challenges, StafGo presents a solution—a beacon of hope in the storm. Our expertise in healthcare financial management positions us as a strategic partner, equipped to assist organizations in navigating these turbulent waters. We firmly believe that denial doesn't have to spell defeat; it's an opportunity for recovery. With the right approach, up to two-thirds of rejected claims can be reclaimed.

Strategic Solutions for Financial Recovery

Our strategic solutions are meticulously crafted to align with payer requirements, ensuring an optimized recovery process. StafGo stands ready to assist healthcare organizations in unlocking financial stability, optimizing recovery, and securing a robust financial future.

StafGo Health: Navigating Financial Storms, Ensuring Stability

In conclusion, the healthcare landscape is evolving, presenting challenges that demand innovative solutions. StafGo Health emerges as a partner dedicated to addressing the financial pressures faced by healthcare organizations. Join us in the pursuit of financial stability, strategic recovery, and a resilient future.

References:

 Claims Denials: A Step-by-Step Approach to Resolution By Leigh Poland, RHIA, CCS, and Srivalli Harihara, CPC, PGPAIML

"A Proactive Outpatient Remittance Model Improves the Hospital's Bottom Line and Positively Impacts the Patient Experience." Becker's Hospital Review, August 12, 2021.

Gooch, Kelly. "4 Ways Healthcare Organizations Can Reduce Claim Denials." Becker's Hospital Review, July 18, 2017.