Revenue Cycle Insights & Policy Briefings
Practical tactics, CMS regulatory breakdowns, and data analysis to help you recover earned healthcare revenue.
What the CMS-0057-F Disclosures Reveal About Commercial Payers in 2026
For the first time in US healthcare history, federal law mandated that insurers publish standard prior-authorization denial and overturn rates. Here is what the numbers prove.
The 65% Problem: Why Most Denials Are Never Appealed (And How Math Fixes It)
According to HFMA, roughly 65% of denied medical claims are never appealed. That is not negligence — it is simple arithmetic. Here is how automation flips the equation.
How to Build a Denial Work Queue Prioritized by Expected Value
Stop sorting your denial queue by FIFO or pure dollar amount. Here is the mathematical formula top revenue cycle teams use to maximize recovered dollars per hour.
Where AI Actually Belongs in the Revenue Cycle (And Where It Does Not)
67% of providers believe AI can improve claims, but only 14% have implemented it. Here is the blueprint for safe, HIPAA-compliant AI adoption in billing.
See what your denials are actually worth.
Send us one month of 835 remittances under a signed BAA. We'll show you exactly how many dollars are recoverable — before you pay anything.