New study reveals over 30% of inpatient claims unpaid to hospitals by commercial insurers for three months or more in Q1 2023, with 15% initially denied: Crowe Revenue Cycle Analytics

One in three inpatient claims submitted by providers to commercial insurers in first quarter 2023 weren’t paid for over three months and 15% of inpatient and outpatient claims were initially denied, according to data from over 1,800 hospitals and 200,000 physicians analyzed by Crowe Revenue Cycle Analytics. That’s nearly three times the number of claims delayed that long in traditional Medicare and over four times the initial denial rate for traditional Medicare claims over the period, the study found. It also found that eight cents of every dollar providers bill to commercial insurers will never be received or will be taken back once received.
 
“Providers feel that they are being forced to jump through hoops and undergo labor-intensive processes in order to receive payment, especially from commercial payors,” said Colleen Hall, managing principal of the healthcare group at Crowe. “During a time when labor shortages persist and expenses continue to rise, hospitals’ believe that their time and resources should be spent directly on patient care rather than managing increasingly bureaucratic reimbursement issues with insurers.”