Inovalon Research Pinpoints Preventable Causes of Claim Denials and Prior Authorization Delays — Inovalon Holdings, Inc.

Event summary

Inovalon's research, based on a national survey of over 400 revenue cycle management leaders, identifies front-end workflow challenges as the primary driver of claim denials.
46% of executives and 38% of managers cite denials as a top revenue cycle challenge, highlighting both financial and operational strains.
93% of organizations still rely on manual processes for prior authorization, with only 7% using dedicated software.
Inovalon's six-part research series aims to improve financial performance by preventing issues before they become denials.

The big picture

Inovalon's findings underscore a broader shift in revenue cycle management, where the focus is moving from fixing problems post-denial to preventing them through connected patient access and predictive intelligence. The research highlights significant inefficiencies in prior authorization processes, which are costly and time-consuming for providers. As healthcare organizations increasingly rely on data-driven solutions, the ability to integrate advanced analytics into workflows will be crucial for improving financial outcomes.

What we're watching

AI Adoption: How predictive AI will shift denial prevention upstream through earlier workflow intervention and smarter claim preparation.
Automation Trends: Whether the healthcare industry can move beyond manual prior authorization processes to reduce operational friction.
Financial Impact: The pace at which providers can improve financial performance by preventing revenue cycle issues before they escalate.