New Industry Research Findings Highlight the State of Payer Reimbursement in 2024

Press Releases

May 01, 2024

As economic uncertainties and staffing shortages plague today’s healthcare leaders,
many are going back to the basics to increase efficiencies and streamline revenue cycle operations

TAMPA, Fla., May 1, 2024 /PRNewswire/ — Encoda, a leader in healthcare reimbursement technology, has released new research findings that show the intricate balance between financial sustainability and patient care.

The State of Payer Reimbursement in 2024: It’s Time to Stop Living in Denials is based on independent, commissioned research conducted by healthcare consultancy Sage Growth Partners in February 2024. Sage surveyed 84 medical practice leaders and administrators, C-suite executives and others familiar with the billing process at both single-specialty and multi-specialty medical practices.

“Our research has found that we are seeing a broken system, one that falls well short of helping practices ensure they are getting every piece of earned revenue they need to deliver quality care,” said Lisa Taylor, CEO, Encoda. “Respondents have told us that they spend more than 41% of their time thinking about the state of their revenue cycle, which equals nearly 3.5 hours each day. With shifting payer requirements and other challenges impacting returns, it is no wonder healthcare leaders are looking for new ways to optimize their financial operations.”

Key findings of the research report include:

  • Only 25% indicate they are confident their practice is receiving every dollar that is earned from each submitted claim.
  • 1 in 4 respondents said their staff spends too much time on revenue cycle management.
  • 51% said that they would be comfortable exploring artificial intelligence (AI) as a way to improve their revenue cycle.
  • 40% of responses indicate medical claim denial rates are between 10-30% of their submissions.

“We know that transparency and efficiency are crucial parts of the reimbursement process. With today’s claims and denials processes constantly leaving money on the table for practice leaders, there is an urgent need for more streamlined solutions and data insights,” said Sam Ambrose, Vice President of Strategic Partnerships, Encoda.

For more information on the research, or to download a complete copy of the report, visit encoda.com. Encoda will also be hosting a webinar on June 13 to discuss the findings, with more information on their website.

About Encoda 
Encoda is the leading claims and denials software solution that acts as the connective tissue between practice management systems, clearinghouses and payers. In turn, we give practices greater visibility into their claims data, allowing them to address denials more efficiently—and more profitably. Drawing from 30 years’ experience developing and implementing revenue cycle software solutions, the team at Encoda is dedicated to revolutionizing healthcare reimbursement automation. And by doing so, Encoda is enabling customers to grow their businesses while significantly reducing back-office resources.

Today, Encoda realizes the true intention of healthcare reimbursement by enabling our clients to collect the most amount of money, in the shortest amount of time, as cost effectively as possible. How do we do that? By using our customizable, rules-based solution to bridge the workflow gaps between payers, clearinghouses, and practice management systems—allowing our customers to get every penny possible from the payers. Learn more at encoda.com

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SOURCE Encoda LLC

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