Insurers denied more claims on clinical grounds in 2025 compared with 2024, leading to a 25% increase in net revenue leakage at hospitals, according to a new report by Kodiak Solutions. Denials and an ...

Many health systems are treating climbing denial rates as a documentation problem. They’re not. They’re the output of a deliberate, structural shift in how payers operate—one that has outpaced what ...

Denial rates have soared to unprecedented levels, transforming what was once a back-office nuisance into a boardroom-level issue for health systems. At Becker’s 13th Annual CEO + CFO Roundtable, two ...

Hospitals are facing a steady rise in payment disputes over their assignment of a Diagnosis Related Group (DRG). These disputes fall into two general categories: coding-based DRG downgrades and ...

AI advances in the last few years are changing this. LLMs have made it possible to parse through unstructured information in minutes. Combined with human expertise, it opens the door to working a much ...

When it comes to managing denials, Michelle Katz has a golden rule: be persistent and document everything. “Documentation is key and it’s a big pain in the butt, but it needs to happen – from all ...

BOCA RATON, Fla., July 9, 2025 /PRNewswire/ -- For the fifth consecutive year, Knowtion Health, a leading healthcare revenue cycle company offering deeper, broader, and smarter revenue recovery ...

In 2011, the U.S. Government Accountability Office found that as many as 40 percent of all healthcare insurance claims made in one state were denied by commercial payers. While subsequent studies by ...

HURC’s CUR solution provides a fully integrated technology and expert resource model to overcome the limitations of common partial solutions, such as technology-only or outsourced staffing models, to ...

Denials are a constantly moving target due to factors often outside of a health organization’s control, such as new payer rules or patients switching medical plans. However, if left unresolved, ...

Accurate medical coding isn’t just about compliance—it’s the key to faster reimbursements, fewer denials, and stronger revenue flow. From CPT and ICD updates to strategic modifier use, skilled coders ...