The patient access solutions involves denials management, payment estimation and Improve patient collections. Denial management has an important role to play in hospital revenue generation. Most hospitals are now dependent on third-party providers for denial management services, as they lack the expert knowledge and time to manage the reimbursement process. These providers, with dedicated and skilled professionals, handle the denied claim and resubmit them. With their expertise, these providers increase the cash flow of their clients, which is otherwise neglected by the hospitals. It is estimated that over 90% of claim denials can be prevented with support from the providers, who have systems and knowledgeable experts in the field. Thus the rising need to eradicate claim denials is expected to contribute for the growth of patient access solutions market in the forecast period.

Key Market Trends

Claim Denial and Appeal Management Segment is Expected to Dominate the Market in the Forecast Years

Based on Software, the market is segmented into Claims Denial & Appeal Management Solutions, Payment Estimation Solutions, and Others. Claim denial and appeal management involves the review of the denial procedure and determining if the denial can be appealed against. The management conducts a root cause analysis for the claim being denied by the insurer. This involves the review of patient documentation and resubmission of the claim. With more healthcare facilities under intense scrutiny and the rise in the number of healthcare claims, a large amount of hospital revenue is being declined by insurers. Hence, with the increasing acceptance of companies that provide these services, they have become more important to hospital facilities, thereby, contributing to the growth of the market studied over the forecast period.

North America Holds the Largest Share in the Patient Access Solutions Market

The Patient Access Solutions market holds the largest share in the North America region due to the presence of a high-quality healthcare system and modern medical technology. Most hospitals in United States that are serving patients, who are covered under Medicare or any privates insurances are facing difficulty in processing and submitting claims. Hospitals face challenge in accurately billing patients for a procedure or surgery done. This has created a huge opportunity for companies that provide patient access solutions to bridge the gap. Additionally, most hospitals in United States having recognized that automating the payment estimation with help of IT tools is helping both hospitals and patients to understand the costs in real time and collect payments by reducing the accounts receivable turnaround time. This is likely to contribute towards the growth of the market.

Competitive Landscape

The global players into the patient access solutions market are AccuReg Software, Cerner Corporation, Cirius Group Inc., Cognizant, Conifer Health Solutions, LLC, Epic Systems Corporation, Experian PLC, McKesson Corporation, Optum Inc. and ZirMed Inc.

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