Notes from the revenue cycle
What we see in billing, denials, prior authorization and practice operations.
CO-18 Denials: Find the Duplicate Before You Rebill
A practical workflow for CO-18 duplicate claim denials: compare claim history, identify the matching line, and correct only what actually failed.
Revenue cycleCO-29 Timely Filing Denials: Build the Proof Before You Appeal
How to work a CO-29 timely filing denial using payer deadlines, submission reports, acceptance records, and corrected-claim history.
AI voiceAI Voice Calls in Healthcare: Where They Actually Save Staff Time
Five practical AI voice-call workflows for healthcare, plus the identity, escalation, consent, PHI, and audit controls each one needs.
AI voiceAI Voice for Payer Claim Status Calls: What It Must Bring Back
A field-level guide to AI payer claim-status calls: authentication, claim matching, structured results, evidence, and human escalation.
OperationsThe Eligibility Verification Checklist That Prevents Avoidable Denials
A front-end eligibility checklist covering identity, coverage dates, benefits, referrals, authorization, COB, and evidence retention.
Revenue cycleERA vs. EOB: What Each One Does in Payment Posting
The difference between an electronic remittance advice and an explanation of benefits, plus a safer workflow for posting and reconciliation.
AI voiceAI Appointment Calls Without More Front-Desk Cleanup
How to design AI appointment confirmations, cancellations, rescheduling requests, voicemail handling, write-back, and escalation.
Revenue cycleCO-16 Denials: How to Find What's Missing and Fix It Once
CO-16 says a claim is missing information but not what. How to read the remark code, route the fix to the right team, and choose between a corrected claim and a new one.
AI voiceAI Voice for Prior Authorization Follow-Up: A Safe Workflow
A practical AI voice workflow for prior-authorization follow-up calls, from case matching and status capture to deadlines and escalation.
OperationsAutomated Claim Status: What a Useful Worklist Should Return
How to turn claim-status responses into actionable billing work using identifiers, normalized statuses, aging rules, and exception routing.
OperationsPrior Authorization 2026: 40% of Practices Staff It Full Time
AMA's survey of 1,000 physicians finds practices complete 40 prior authorizations weekly, and 40.0% now employ staff solely for that task.
AI voiceAI Patient Billing Calls: Guardrails for Payments and PHI
How to scope AI patient billing calls around identity, balance explanations, payment security, disputes, hardship, escalation, and consent.
Revenue cycleDenial Management Now Eats Up to 75 Hours a Week
Adonis's 2026 survey of more than 120 revenue cycle leaders found most healthcare organizations spend 50 to 75 hours a week managing claim denials alone.
Revenue cycleRCM Outsourcing in 2026: 69% Now Outsource Part of the Cycle
In 2026, 69% of hospitals and medical groups outsource part of the revenue cycle, with accounts receivable follow-up outsourced most at 67%, HFMA data shows.
Revenue cycleHow Automation Saved U.S. Healthcare $258 Billion in 2024
The 2025 CAQH Index found electronic transactions saved U.S. healthcare $258 billion in 2024, while manual prior authorization still costs $10.97 a claim.
TechnologyRevenue Cycle AI in 2026: 27% at Scale, 53% Piloting
Only 27% of health system revenue cycle teams run AI at scale in 2026, HFMA's survey of 95 finance leaders found, and 53% are still just piloting programs.
Data integrityWhy Your EHR and Billing Reports Never Match
EHR and billing reports rarely agree because they measure different things, not because one system has an error.
Revenue cycleWhat Prior Authorization Actually Costs a Practice in Staff Time
A plain-language method for turning the AMA's prior authorization time burden into a dollar figure a practice can calculate.
Revenue cycleThe Full Cost of an In-House Billing Department
Most published comparisons of in-house versus outsourced billing cost are written by billing vendors; here is how to build your own instead.
Revenue cycleWhich Denied Claims Are Worth Appealing
Most denied claims are never appealed even though most filed appeals succeed, and a cost comparison can show which denials are worth the effort.
Revenue cycleWhat a Normal Denial Rate Looks Like in 2026
A look at the current claim denial benchmarks, why they vary by payer, and how to compare your own rate against them.
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