HIT Consultant June 24, 2025
In the complex and often frustrating world of healthcare billing, claim denials, underpayments, and repeated resubmissions are among the most persistent and costly challenges faced by providers. The process is time-consuming, error-prone, and resource-intensive which results in wasted time and detracts from patient care. Fortunately, advanced machine learning (ML) and artificial intelligence (AI) are transforming this process, by helping providers reduce the time, cost, and frustration associated with claims remediation.
Understanding the Burden of Claim Remediation
Claim denials can occur for a wide variety of reasons, most often from incorrect coding, missing documentation, authorization issues, eligibility issues, or simple human error. For example, according to a report from Premier, nearly 15% of claims submitted to private payers initially were denied,...
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