How Improving Patient Access Technology Can Reduce Denials and Boost Revenue in Healthcare Revenue Cycles

April, 25 2025

Patient access is a growing point of opportunity for revenue cycle leaders to reduce preventable denials and increase revenue—if you leverage the right patient access technology.

Patient access is a foundational point in the revenue cycle for hospitals and health systems, directly impacting a patient’s ease in receiving care. It comprises administrative processes including:

• Appointment management and scheduling
• Registration
• Insurance verification
• Financial counseling
• Billing and payments
• Patient communications

Issues in any of these processes can have negative downstream impact on denials, revenues, and the patient experience. For example, failures in insurance verification can lead to submission to the incorrect payers and severe delays in revenues, especially if claims submission timelines are missed.

Reported rates of denials are increasing at an alarming rate, but the vast majority are preventable. This is especially true for denials that originate in patient access and cascade through the rest of the revenue cycle. In 2022, 22 percent of healthcare staff said denial rates were increasing—this number jumped to 73 percent in 2024.

Revenue cycle leaders who want to reverse these denial trends will need a granular understanding of the root causes of their front-end rev cycle issues and a solid grasp on the patient access technologies that have the strongest potential to mitigate denials and reverse revenue leakage.

Patient Access Issues Are a Root Cause of Denials

It is impossible to address denials rooted in patient access issues without understanding the most common potential causes. According to 2024 SSI data, front end issues make up the top reason for denials at 32.5% of total denials. These issues include:

• Incomplete or Inaccurate Patient Information: Patient access staff are tasked with collecting and verifying information during registration. Incorrect information can lead to clean claim rejections, delaying reimbursement from payers, and taking up valuable staff time in the resubmission process.
• Insurance Eligibility Issues: If patient access staff fail to verify coverage details, the risk of denied claims increases. When this information is incorrect, it can translate into downstream rejections for myriad reasons, including incorrect payor or plan information and issues with insurance primacy.
• Authorization and Referral Lapses: Pre-authorization requirements vary by payer, so failing to follow them specifically can contribute directly to denial and reimbursement issues. In 2023, the Healthcare Financial Management Association (HFMA) found that front end revenue cycle errors were the top cause of claim denials, including eligibility errors and missed prior authorizations.

Denials Are Destroying Revenue for Hospitals and Health Systems

The American Hospital Association reports that hospitals and health systems spent almost $20 billion in 2022 overturning denied claims. The average cost to fight a claim is $43.84. This only paints part of the picture of the impact of denials on hospitals and health systems.

Cash Flow Slows

Issues in patient access can cause severe negative impact to critical revenue cycle performance KPIs, including Aged A/R and bad debt. When accuracy and efficiency slows in patient access, clean claim rates drop, stagnating collections and jeopardizing the financial stability of healthcare providers.

Administrative Burden Grows

Administrative costs have ballooned to 40% of the cost of caring for hospital patients, according to the American Hospital Association (AHA). The same survey found that 50 percent of hospitals and health systems reported over $100 million in AR for claims older than six months.

The full cost of administrative burden is difficult to calculate, but it encompasses multiple factors, including:

• The work of revenue cycle recovery teams in review, appeals, and followup
• Billing and coding staff claim correction and rework
• The opportunity cost of staff being pulled away from higher value tasks to manage denials that could have been averted.

Refresh Patient Access to Reduce Preventable Denials and Stop Revenue Leakage

The nature of patient access denials means that hospital and health system administrators have higher levels of control in turning around their numbers of preventable denials. This happens in three key areas of opportunity in refreshing patient access.

1.   Implement Robust Eligibility Verification

The value of strong eligibility verification can’t be overstated. Improving accuracy in verifying patient identity, demographic information, active coverage and eligibility improves clean claim rates, reduces payer reasons for denials, and saves on the administrative headache of claim correction and rework. These benefits scale when provider leadership implements bill estimation tools to free up revenue cycle staff, ensure accurate insurance information, and improve patient collections.

2.   Invest in Staff Education

Patient access challenges vary by insurance company, meaning that revenue cycle staff needs granular understanding of each payer and their requirements. Front-end staff, as well as billers and coders, should be provided with comprehensive training to help them stay on top of payer-specific requirements, plan changes, and other potential challenges that crop up during patient intake.

3.   Leverage Patient Access Technology

The shortage of expert revenue cycle team members and consumers frequently switching insurance plans has led to a perfect storm for potential eligibility verification errors that can result in higher denial risk and negatively impact reimbursement. Set the tone for a strong revenue cycle and positive patient experience with sophisticated patient access management tools that integrate with your existing hospital systems. SSI’s patient access management platform, Access Director, helps relieve the burden of complicated registration and collections processes, allowing front-line staff to focus on patients rather than policies.

Achieving Patient Access Excellence at Your Organization

As the complexity of denials grows and payer requirements become more complex, most providers will continue to see the cost of inaction increase—both in the form of lost revenue and rising revenue cycle costs. Fortunately, with high rates of manual processes, many providers have significant opportunities to not only improve denials metrics, but to turn them into an advantage for their teams and their organizations.

Patient-centered care requires rethinking patient access and reframing it in a way that turns front-end revenue cycle interactions into an opportunity for patient connection and increased efficiency. Healthcare providers should strive to create a patient access process that is part of a broader goal of an improved healthcare experience—an experience where registration and scheduling are transparent, easily navigable, and patient friendly.

Making these goals a reality starts with understanding where you are now in your patient access processes—identifying KPIs, assessing patient experiences, and listening to staff about challenges and inefficiencies. Once you understand your starting point, it’s significantly easier to identify the RCM service providers who can supplement your efforts with their deep experience with patient access challenges, solutions, and potential future refinement. This relationship is a partnership—one that should extend into the future as you advocate for ongoing training and adoption of best practices that are flexible enough to keep up with shifting regulations and evolving patient needs.

By prioritizing and optimizing patient access, healthcare providers can significantly reduce claim denials, enhance revenue streams, and improve overall patient satisfaction.

Want to learn more about ways to mitigate eligibility-related denials?

• Read this Definitive Guide to Preventing Eligibility Denials to explore further.
• Request a demo of Access Director to review where we can best fit in your future of patient access.
• Visit this page to learn about SSI’s Access Director solution

Legasse, Jeff. 2021. “More than 30% of Hospitals Are Near the ‘Danger Zone’ of Denial Rates.” Healthcare Finance News. June 18, 2021. https://www.healthcarefinancenews.com/news/more-30-hospitals-are-near-danger-zone-denial-rates.

LaPointe, Jacqueline. 2025. “Common Denial Reason Codes in Medical Billing.” Rev Cycle Management. TechTarget. 2025. https://www.techtarget.com/revcyclemanagement/feature/Common-denial-reason-codes-in-medical-billing.

LaPointe, Jacqueline. 2023. “Patient Access, Registration Errors Lead to Most Claim Denials.” Xtelligent Rev Cycle Management. TechTarget. October 25, 2023. https://www.techtarget.com/revcyclemanagement/news/366600262/Patient-Access-Registration-Errors-Lead-to-Most-Claim-Denials.

“Payer Denial Tactics — How to Confront a $20 Billion Problem | AHA.” 2024. American Hospital Association. May 6, 2024. https://www.aha.org/aha-center-health-innovation-market-scan/2024-04-02-payer-denial-tactics-how-confront-20-billion-problem.

Cass, Andrew. 2024. “Claims Denials Are Costing Hospitals Nearly $20B per Year.” Becker’s Hospital Review | Healthcare News & Analysis. Becker’s Hospital Review | Healthcare News & Analysis. March 25, 2024. https://www.beckershospitalreview.com/finance/claims-denials-are-costing-hospitals-nearly-20b-per-year/.

“Skyrocketing Hospital Administrative Costs, Burdensome Commercial Insurer Policies Are Impacting Patient Care.” 2024. American Hospital Association. September 2024. https://www.aha.org/system/files/media/file/2024/09/Skyrocketing-Hospital-Administrative-Costs-Burdensome-Commercial-Insurer-Policies-Are-Impacting-Patient-Care.pdf.