Focusing on high-dollar denials feels like a smart RCM strategy.
After all, today’s depleted RCM teams only have so much capacity. And a $575 claim doesn’t seem worth the same effort as the $5,000 claim sitting right underneath it.
Which is what payers are counting on.
They’re using AI to overwhelm business offices with denials, knowing that most can’t keep up. So, a $575 claim here. A $350 claim there. They get written off.
Individually, that’s nothing. But when you add all these smaller claims up? Well, it turns into something pretty quickly.
$575 written off
$1150 written off
$2875 this week
$11,500 this month
$138,000 this year
*These numbers are hypothetical but based on industry trends
For healthcare organizations, cherry-picking denials isn’t the answer.
Building an AI-driven process that scales without tradeoffs is.
