How AI Can Increase the Success of Clinical Denials Appeals

AI augments human expertise to reduce clinical denials appeals, reduce AR days and improve financial performance for providers.

It’s a perfect storm of financial pressures facing healthcare provider organizations – from rising costs to labor shortages to constrained capacity – that stymies revenue growth. Growing challenges with payer payments only exacerbate these issues. According to a Kaufman Hall report, 73% of leaders surveyed said claims denials, which was the top revenue cycle issue in 2022, had increased in 2023.

The cost of denials is staggering. A recent data analysis revealed that providers spent nearly $20 billion in 2022 on efforts to resolve delays and denials across payers. More than half of the total – about $10.6 billion – came from denied claims that were appealed and ultimately paid. 

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