INFOGRAPHIC

The Denials Dilemma:
Close Coverage Gaps at the Source

Denials continue to drain

For post-acute providers, denials aren’t just operational setbacks – they’re daily disruptions that are costly, disheartening, and avoidable with the right tools.

A light blue circular progress bar is nearly complete around a white icon of a person pushing a walker, symbolizing mobility aid or elderly care—potentially highlighting concerns like healthcare staff burnout. The background is light gray.

68% of skilled nursing facilities say claims denials are a significant challenge1

A light blue circular progress bar, highlighting burnout staff, features a small grayish-white unfilled segment around a house icon with a heart at its center. The light gray background adds to the focus on staff burnout awareness.

83% of home health and hospice organizations say the same1

The #1 contributor to this problem is front-end breakdowns like prior authorization issues, invalid claims data, and insurance eligibility gaps1.

The desire for early confirmation, less stress

87.8%

Percentage of post-acute leaders who wish they could confirm eligibility and retrieve Medicare Beneficiary Identifier (MBI) before delivering care.2

When eligibility and coverage details are unclear:

Icon of a document with a warning triangle and exclamation mark, above the words Claims stall—symbolizing how staff burnout can lead to delays or issues in claims processing.
Icon of three stylized people with slouched postures and circles above their heads, symbolizing staff burnout or fatigue, above the text Staff Burn Out. Perfect for illustrating healthcare staff burnout issues.
A bar chart with decreasing bars and a downward arrow above them, representing a decline. Below the chart, the text reads Revenue takes a hit from healthcare staff burnout.

These aren’t abstract issues; they’re barriers standing between your team, the care you deliver, and the revenue you rely on.

The message is clear:
front-end visibility isn’t just helpful, it’s foundational.

It’s time to rethink the front-end

  • What if eligibility checks weren’t a frantic, last-minute task?
  • What if MBI lookups didn’t require workarounds?
  • What if your team had time to focus on higher-value work, and had the tools to move with confidence?

That’s the new vision for the post-acute revenue cycle:
smarter, earlier, and far more resilient.

What leading organizations are doing now

Innovative teams are closing coverage gaps at the source, shifting their attention to the earliest stages of the patient or resident journey – and our solutions are helping them make that shift.

Text that reads Inovalons Eligibility Verificationâ„¢ on a white background with a faint blue and tan border, designed to help reduce healthcare staff burnout.

Discover the power of automated batch checks for real-time
coverage, integration with your EHR, and MBI retrieval.

  1. Claims Denials: Causes, Impact, and AI-Enabled Prevention Strategies, Inovalon, Oct 21, 2024, https://www.inovalon.com/resource/claims-denials-causes-impact-and-ai-enabled-prevention-strategies/
  2. Internal survey, Inovalon, February 2025