Why Engaging Experts in Revenue Cycle Management and Leveraging Smart Technology Matters More Than Ever
Every year, over 850 million healthcare claims are initially denied in the U.S. — a staggering number that reveals a deeper problem in our revenue cycle systems. According to a Change Healthcare report, 30–40% of these denials are due to manual errors and coding mistakes, many of which are entirely preventable.
Even more alarming, while over half of these claims are eventually overturned, the cost to do so is immense. Providers collectively spend over $20 billion annually on claim reviews and appeals. But it doesn’t end there — an estimated $10.6 billion is permanently lost to denials that should have been paid correctly the first time (Change Healthcare, 2020).
Despite the rise of automation, physicians are still deeply entangled in billing. A 2016 study published in Health Affairs found that primary care offices spend about 13 minutes per billing episode, while ER and inpatient surgical billing take 32 and 100 minutes, respectively (Tseng et al., 2018). Shockingly, 3 to 15 minutes of that time is the physician’s own, pulling attention away from patients and contributing to burnout.
This is where HealthIQ steps in. Our team have spent years specializing in medical billing, medical coding and end-to-end revenue cycle services. We are able to eliminate manual errors, reduce rejections and denials and reclaim lost revenue with persistent A/R calling. Our teams work in real-time, aligned with your office hours, ensuring seamless coordination, faster reimbursements, and fewer headaches. We also do all your practice management and administrative tasks like patient intake, new patient registration, insurance verification, prior authorization, patient scheduling and more.
Fortunately, AI and machine learning technologies are also helping. HealthIQ is developing its own RCM agentic AI. From automating code selection and verifying documentation to predicting and preventing denials, artificial intelligence is helping providers streamline workflows and make smarter decisions. AI can flag missing data, correct code mismatches in real-time, and even learn payer-specific denial patterns — drastically reducing errors before submission and improving claim acceptance rates. Medical billing and revenue cycle management are critical for a healthcare provider’s financial. They shouldn’t be a road block to success and it definitely shouldn’t cost billions in waste. It’s time to rethink your billing and RCM strategy. Should you need to talk to professional experts, do get in touch with us.
