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Revenue Cycle: Claims Denials & Payer Audits
“CentraCare Health has denials sitting out there for 300 days, creating administrative and financial burden, says rev cycle director.”
A recent article in Healthcare Finance News details how heavy reliance on AI algorithms to tackle claims processing can lead to privacy issues, inaccurate results, and complexities that divert focus from the patient.
HURC believes in empowering doctors and nurses to focus on elevating patient care. Our UR Services and Revenue Cycle Optimization Solutions have brought about denial coordination with rapid rule change adoption and specialized payer/provider communication & reconciliation to give providers the advantage.
HURC works with healthcare professionals to harness hospital systems' existing infrastructure, saving millions and bringing back the focus of care to what really matters: the patient.
Visit HURC.com for more information - and learn more about our approach as it pertains directly to Revenue Cycle here.
How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them
ProPublica's article contains a deeper dive into Cigna Healthcare's claims denial conflict while touching upon common issues within the prior authorization process.
Cigna hit with second class action suit over claims automation software
With the rollout of AI and automation in the healthcare industry, it's essential to be aware of its dangers when left unchecked. Healthcare Dive reports on Cigna's second class action lawsuit over its software that automates claims processing.
Lawsuits allege that Cigna's "procedure-to-diagnosis" (PxDx) software rejected over 300,000 requests for payment in 2022 in the absence of medical professional oversight. Further investigation is occurring, and you can learn more here.