HealthLeaders Media ANALYSIS: Rev Cycle Leaders Call Out Two Major Players in Their Fight with Payers

(February 24, 2023)

Revenue cycle leaders agree they need to unite against one common enemy: the payer.

KEY TAKEAWAYS

  • Revenue cycle leaders have always sparred with payers. It’s so much worse lately.
  • It's not uncommon for payers to impose new policy changes throughout the year and in the mid-contract period.
  • The relationship between a provider and a payer organization rests on proactive communication, but what if that relationship seems one sided?

Payer compliance was a hot topic for the revenue cycle executives attending the recent HealthLeaders Revenue Cycle Exchange in Carlsbad, CA. Regulatory burdens and never-ending denials are putting massive strains on revenue cycles, and leaders agree they need to unite against one common enemy: the payer.

When it comes to payer compliance, revenue cycle leaders agree there are two major players in the industry that cause the most headaches for them right now: United Healthcare and Blue Cross Blue Shield (BCBS).

According to a poll of the 35 leaders conducted at the event, 44% of attendees chose both United Healthcare and BCBS as the most difficult payers to work with. These results were interesting as other payers came in far behind at 5% for Aetna, 5% for Humana, and 0% for Cigna.

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