Managing post-acute denials remains a critical challenge – one that drains valuable time, money, and staff resources that could be better spent on care. Despite providers’ best prevention efforts, denials continue to disrupt cash flow and demand constant attention.
Claims denials are a top revenue cycle priority according to Inovalon’s survey of over 400 healthcare leaders across hospitals, health systems, and post-acute providers.1 Among postacute providers specifically, 74% of leaders cite denials as a significant concern.1
3 Trends in Post‑Acute Denial Management
1 | Claims denials are a significant concern
33% identify denials as a top challenge1
41% say denials are an important challenge1
Post-acute leaders are feeling the pressure –
denial management is a critical priority that can’t be ignored.
2 | Authorization and data issues drive denials
identify denials as a top challenge1
missing or invalid claims data1
Prior authorization processes and data quality issues
have emerged as the primary culprits behind claims denials in long-term care.
3 | Too much staff time is required
29% experience denials every day2
37% experience denials every week2
missing or invalid claims data1
The administrative burden is overwhelming as post-acute teams frequently face denials
that force staff to spend valuable time on appeals instead of resident care.
Turn the Tide on Post-Acute Denials in 5 Steps
Position your team to prevent denials before they happen with Inovalon’s claims management solutions. With 98% or better first-pass payer acceptance,3 AI-powered analytics, and automated workflows, our specialized software helps you reclaim lost revenue and redirect staff time back to resident care.
Supercharge your denial prevention:
1. See exactly where your denials originate with advanced analytics.
2. Uncover hidden revenue recovery potential with smart insights.
3. Eliminate bottlenecks and reduce errors with simplified processes.
4. Expedite routine tasks with automated workflows.
5. Manage everything from one unified system.
Ready to Reduce Denials and Boost Revenue?
- “Claims Denials: Causes, Impact, and AI-Enabled Prevention Strategies,” Inovalon, accessed September 10, 2025, https://www.inovalon.com/resource/claims-denials-causes-impact-and-ai-enabled-prevention-strategies/.
- “Survey: Medicare Advantage Denials of Post-Acute Care Occur Daily, Weekly for Two-Thirds of Nursing Homes,” AHCA/NCAL Press Release, August 27, 2025, https://www.ahcancal.org/News-and-Communications/Press-Releases/Pages/Survey-Medicare-Advantage-Denials-For-Nursing-Homes-.aspx.
- Inovalon internal reporting, Claims Management Pro, February 2025.
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