From back office to balance sheet: Why revenue cycle is becoming strategic AI infrastructure
Healthcare finance leaders are confronting a new reality: Revenue cycle performance now directly influences organizational stability, capital planning and access to care. Rising denial rates, expanding prior authorization requirements and persistent staffing constraints have transformed revenue operations from a transactional function into a strategic enterprise capability. Recent reporting from Kaufman Hall shows denials and revenue…
HFMA’s Vitalic Health to gather more than 50 payers, providers and tech leaders to address rising claim denials
CHICAGO (Feb. 3, 2026) – The Healthcare Financial Management Association’s Vitalic Health announced today it will convene more than 50 payers, providers and tech companies to simplify and standardize the claims process in U.S. healthcare. Nearly 12 percent of patients’ claims for healthcare services are denied because of procedural requirements, benefit limitations, medical necessity concerns and more – a rising trend each year. Claim denials administration adds an estimated $25 billion in unnecessary spending to the healthcare system. “The relentless rise of claim…
Navigating the rising tide of denials
Managing the healthcare revenue cycle is more challenging — and more critical — than ever. Amid sluggish margins, ongoing staffing challenges and rising costs, providers feel unprecedented pressure to optimize their revenue cycles. Addressing the ever-increasing issue of denials is a great place to begin. The latest data on denials and proven strategies to reduce…
Navigating payer practices to reduce denials and enhance outcomes
The friction between payers and providers has existed for decades. It’s understandable to an extent. Payers want to reduce expensive and unnecessary treatment, eliminate fraud and lower financial risk. Providers want to be able to make decisions regarding their patients’ care without having to navigate the hurdles of medical necessity, prior authorization and complex payer…