New Inovalon research shows where post-acute claims break down and where the biggest prevention gap is.
Denials Are Still the Top Problem
63%
of post-acute leaders call claim denials a significant revenue cycle challenge.
Inovalon surveyed more than 400 revenue cycle leaders and managers across care settings, including skilled nursing facilities, home health agencies, and hospice providers.
Where Post-Acute Denials Start
Post-acute leaders point to three top drivers of denied claims:
1
Missing or invalid claim data
2
Prior authorization
3
Eligibility verification
27%
Across all care settings, insurance eligibility and benefits verification is the single most-cited cause of denials.
Denials especially for coverage lost or change in insurance.”
– Revenue cycle leader, Inovalon survey
Most Teams Check the Front End. Few Scrub the Back End.
How post-acute organizations try to prevent denials
54%
Validate resident demographic information
54%
Monitor insurance eligibility changes
30%
Use customized claim scrubbing to find and correct errors
Only 3 in 10 post-acute organizations use customized claim scrubbing, compared with 53% of hospitals.
Close the Gap One Click From PointClickCare
With Inovalon’s Claims Management Pro™ on the PointClickCare Marketplace, your billing team can catch errors before claims reach the payer, spot delays sooner, and keep work inside the system you already use.
Catch errors before submission
Every claim is scrubbed for missing or incorrect information and held until it’s clean, with step-by-step guidance for each fix.
Spot problems sooner
Set alerts by payer, claim status, or days unpaid so delayed and denied claims land in the right queue.
Skip the extra logins
Claims and remits move between PointClickCare and Inovalon with single sign-on. No exporting or uploading.
Results From PointClickCare Facilities
90%
First-pass payer acceptance
with Inovalon’s claims management solution
See how PointClickCare facilities are preventing denials before claims go out.
Inovalon, “Claim Denials: Prevention Strategies” white paper (PRO-26-0359), survey of 400+ revenue cycle leaders and managers, 2026. Post-acute figures from the care setting charts on pages 5, 9, and 11; all-settings eligibility figure from page 8.
Inovalon on-demand session, “Extending the Value of PointClickCare Across the Revenue Cycle” (26-0423), presented by Colette Schlegel. Source for the 90% first-pass payer acceptance figure.
Inovalon and design® and Inovalon® are trademarks of Inovalon, Inc.
PRO-26-0865
