Welcome to our blog
Your go-to source for insights and updates on the ever-evolving world of medical clearinghouses. As a vital intermediary between healthcare providers and insurance payers, we understand the complexities of claims processing and the importance of seamless data integration. Our blog is dedicated to providing you with the latest trends, best practices, and innovative solutions to optimize your revenue cycle management.
October 1: Treating Q4 as a Known Eligibility Event
OBBBA work requirements and biannual redeterminations start creating measurable coverage disruption in Q4 2026. Here is how to prepare your eligibility workflow before the disruption hits.
Medicare Advantage Is Denying 1 in 6 Claims: What to Do Now
Medicare Advantage denial rates have reached 17%, more than double traditional Medicare. Here is what is driving the gap, and what practices with MA volume need to do about it.
The Labor Math of Denials: What Denial Work Actually Costs
RCM teams spend 51 to 75 hours a week working denials. The dollars are one measurement. The staff capacity you never get back is another. Here is the full labor math.
Prevention Over Recovery: Why the Industry Finally Flipped
74% of provider executives now prioritize preventing denials over recovering them. Here is what actually changed, and what an operation built around prevention looks like.
Five Questions PM Vendors Should Ask Before Adding AI Denial Prevention
Every PM and EHR vendor is being asked about AI. Before committing to an AI denial prevention roadmap, here are five questions that should shape the answer.
Clean-Claim Rate as a Customer Retention Lever
PM vendor churn is rarely about the software. It is about the outcomes the software drives. First-pass acceptance rate is one of the most visible outcome metrics on that list.