In 2025, external payer audit activity accelerated sharply: at-risk amounts and audit cases per customer rose 30%, the average amount at risk per claim increased 18%, and outpatient coding-related denials climbed 26% year over year after a
In 2025, external payer audit activity accelerated sharply: at-risk amounts and audit cases per customer rose 30%, the average amount at risk per claim increased 18%, and outpatient coding-related denials climbed 26% year over year after a
A revenue cycle director can watch collections hold steady for two quarters and still be losing money every week. The dashboard may show familiar volumes, a tolerable denial count, and no dramatic change in total cash. Meanwhile,
39 prior authorizations per physician per week, plus about 13 hours of staff time, is what the average practice is dealing with in 2024, and 31% of physicians say those requests are often or always denied. For
The biggest mistake in medical billing denial management is treating denials like a cleanup queue. That mindset keeps teams busy, but it doesn't protect cash. Across U.S. healthcare, about 77% of denials are administrative rather than clinical,
A Type 2 NPI is the 10-digit National Provider Identifier assigned to a healthcare organization, not an individual provider. It's the identifier that sits on the billing side of the claim, so the payer knows which legal
The charge nurse sees the chart first, then the silence in the hallway. A patient who was supposed to recover has suffered an unexpected permanent injury, and the team now has a sentinel event on its hands.
