Insights for Healthcare revenue leaders
The healthcare revenue cycle is more complex than ever. At Action RCM, we share practical strategies, executive perspectives, and industry insights to help leaders protect margins, improve patient experience, and accelerate recovery.
COB Denials: The Most Preventable Revenue Leakage in the Hospital Revenue Cycle
In the complex world of hospital reimbursement, few denial categories are as deceptively costly and consistently overlooked as Coordination of Benefits (COB) denials. While clinical, prior authorization, and level-of-care denials often get the most attention, COB...
AI vs. Human: Who Should Manage Denials in Today’s Revenue Cycle Management?
By Action RCM Powered by Harris & Harris In the modern healthcare ecosystem, denials have quietly become one of the most expensive leak points in hospital revenue. On average, 10–15% of all claims are denied at least once, with up to 65% of those denials never...
Cracking the Code: How Hospitals Can Manage Veterans Administration (VA) and TRICARE Denials
Written by: Janice McGoldrick, VP of Revenue Cycle Management As hospitals work to stabilize revenue amid increasing payer scrutiny, Veterans Administration (VA) and TRICARE denials continue to challenge even the most experienced revenue cycle teams. Though both...
MVA & Workers’ Comp Denials: Why They Require a Different Playbook
A Growing Denial Challenge Motor vehicle accident (MVA) and workers’ compensation (WC) claims represent a unique challenge in the healthcare revenue cycle, one that can’t be managed with the same strategies used for commercial or government payer denials. These...
Top 10 Root Causes of Hospital Denials—And How to Prevent Them
Written By: Janice McGoldrick, VP of Revenue Cycle Hospital claim denials remain one of the most persistent and costly challenges in healthcare revenue cycle management. Nearly one in ten hospital claims is denied on first submission, and more than half of those...