Medical Economics January 8, 2026
Key Takeaways
- Healthcare billing complexity, especially with CPT codes, leads to inefficiencies and revenue loss, impacting financial and clinical performance.
- Claim denials are a major source of revenue leakage, often neglected due to their complexity and the pressure on billing teams.
- Key denial metrics, such as First Pass Denial Rate and Denial Recovery Rate, are essential for diagnosing problems and improving processes.
- Billing should be seen as a strategic function, with investments in automation and AI to enhance accuracy and decision-making.
- Accurate billing is vital for financial health, enabling reinvestment in patient care and strategic planning.
Fixing the billing problem isn’t just about collecting more money. It’s about restoring trust and predictability to the business of care.
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