This brief analyzes federal transparency data released by the Centers for Medicare and Medicaid Services (CMS) on claims denials and appeals for non-group qualified health plans (QHPs) offered on HealthCare.gov in 2023. It finds that HealthCare.gov insurers denied nearly one out of every five claims (19%) submitted for in-network services. Information about the reasons for denials is limited, and few consumers appeal claims denials.| KFF
Net collection rate is an important measure of a healthcare provider's revenue integrity. Learn how to increase your rate in our guide.| www.mdclarity.com
Insurance Appeals 'I just know you're going to do a blog post about this!' my friend Lisa told me. Yes, I knew I would. After all, any time I learn something that benefitted my child and could potentially help other children, I want to share the information. Particularly when it comes to navigating a difficult| A Day in our Shoes