By Michael Ford – A growing share of the problem hospitals face today doesn’t come from denials at all. It comes from claims that sit unresolved without ever receiving a formal denial. Why do these claims fall through the cracks?
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By Dalton Han – The Economic of Denials Claims Reimbursement Friction – The easiest way to misunderstand health insurance denials is to count them once and move on. For years, healthcare organizations have treated denials as an administrative metric, a back-office measure reviewed by revenue cycle teams and reported through operational dashboards.
By Hasnain Ali – Healthcare organizations have made significant investments in digital infrastructure, electronic health records, automated claim scrubbing tools, and analytics platforms designed to improve financial performance. Yet despite these advancements, denial rates, delayed reimbursements, and avoidable rework remain common across both independent practices and large health systems.
By Mohammed Vaid – Penalties reduce revenue, but their real significance lies in what they reveal about payer operations. A single error in plan materials can cascade into thousands of disputes, costly claim adjustments, and delayed reimbursements.
By Mike Esworthy – Healthcare providers serving veterans face a growing paradox: While the VA has made tremendous strides in sharing health data through its interoperability initiatives, the financial and administrative challenges of VA claims processing remain largely unresolved.
By Joan Butters – A KFF survey from 2023 revealed nearly one in five adults had health insurance claims denied in the previous year. On a national level, that suggests millions of disaffected patients. The growing public frustration with the cracks in our healthcare industry has exploded into a national conversation.
By Jane Austen – Healthcare revenue cycles struggle with claim denials. Denial management investigates each denial, determines why it was denied, and determines how to fix the problem and reduce future denials. Sophisticated and robust automation, designed to meet providers’ needs and achieved through AI and ML, empowers organizations to…
By Dmitrii Evstiukhin – Medical insurance claims processes create mounds of documents that often get backlogged or denied, slowing business operations and reducing efficiency. Now AI solutions are dramatically accelerating medical claims processing while reducing errors and enhancing overall efficiency.