With complex claims denials increased over 300 percent since 2015, nine in ten providers are turning the complicated complex claims processing to highly adept external vendors. Argos Health receives top client experience ratings in annual polling of chief financial officers and senior business officers in provider organizations as hospital margins continue to diminish.
TAMPA, Fla., March 18, 2021 (Newswire.com) - Black Book Research's annual survey of over 1,300 CFOs, financial management and business office solution users evaluating customer satisfaction with enterprise complex claims management vendors revealed that Argos Health had achieved top client experience and product loyalty user scores.
Eighty-one percent of hospital CFOs surveyed report in Q1 2021 that the costs of denied claims to their health system has reached four percent or more of their net patient revenue.
Seventy-one percent of in-network denials were attributed to reasons of claim complexities (excluding the twenty-nine percent that were denied for typical denials of missing referrals or pre-authorizations, excluded services, and/or medical necessity.
Ninety-five percent of health systems leaders surveyed in the Q1 2021 also report they are now in the process of evaluating, acquiring and/or deploying advanced, external complex claims solutions in defense.
"Write-offs have tripled over the last four years and payers' automated system algorithms are rejecting, downgrading and placing complex claims in very lengthy medical review processes which the typical healthcare business office is not staffed to handle," said Doug Brown, Managing Partner Black Book Research, the study authors. "With the average hospital margin thinning to less than two percent, the need for higher net revenue, improved cash flow and reduced time in accounts receivable is critical to many more organizations' survival in 2021."
Respondent CFO's confirmed that their health systems face long roads to financial recovery ahead, initiating most to seek immediate solutions to their complex claims crises. Sixty-two percent of providers reported operating margins further dropped in February 2021 at least another -0.5%, not including CARES Act funding, while total expenses continue to rise.
Black Book Market Research LLC measures customer satisfaction across 18 copyrighted key performance indicators: Strategic Alignment of Vendor Offerings to the Client's Mission and Goals; Innovation and Optimization; Training and Education; Client Relationships and Cultural Fit; Trust, Accountability, Ethics and Transparency; Breadth of Offerings; Deployment and Implementation; Customization; Integration and Interfaces, Interoperability and Connectivity; Scalability and Client Adaptability; Vendor Staff Expertise and Performance; Reliability; Brand Image and Marketing Communications; Marginal Value Adds; Vendor Financial Viability and Managerial Stability; Data Storage Services; Support and Customer Care; and Best of Breed Technology and Process Improvement.
Argos Health achieved top user honors in 13 of the 18 complex claims solutions' specific KPIs.
The full listing of financial digital transformation product rankings in multiple functional categories can be found at Black Book's website: https://blackbookmarketresearch.com/finance-revenue-cycle-management.
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Source: Black Book Research