HealthIT Answers June 16, 2025
Healthcare finance executives face an intensifying storm of audits, denials, and clawbacks that threaten their organization’s financial stability. Couple that with an environment of heightened regulatory and payer scrutiny, and it becomes clear that proactive risk monitoring and AI-driven compliance strategies are no longer optional—they are imperative.
Aggressive Action
An internal analysis of over $8 billion in audited professional and hospital claims and over $150 billion in denials collected from over 650,000 providers and more than 2,200 facilities identified surging audit volumes and claim denials in the past year. Our annual benchmark report documented that audit volumes more than doubled over 2023 rates while total at-risk dollars increased fivefold to $11.2 million, straining provider organization cash flows.
Payer scrutiny, particularly...
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