Healthcare Business Today recently featured an article by Adele Frias, Vice President of Specialty Revenue Cycle Solutions at EnableComp, on a problem hospitals can’t afford to normalize: Denied claims are no longer occasional friction, they’re a persistent revenue threat that chips away at already-thin margins.
In the article, Frias explains why denials have become so hard to manage, pointing to an increasingly unpredictable payer environment, policy changes with little warning, mid-cycle contract shifts, and even flawed AI-driven claim flagging that can derail clean claims. She also calls out how contract language can quietly tilt power toward payers through hidden clauses, weakening provider leverage unless agreements are reviewed and negotiated with the right stakeholders at the table.
Frias then outlines what it takes to regain control: a more proactive, data-driven approach that combines pattern visibility (including AI to spot denial trends), stronger team readiness to understand payer behavior, disciplined contract review, and the right expertise and partnerships to escalate and recover what’s owed. Her message is clear: Health systems can either treat denials as the cost of doing business, or change the rules and protect revenue with intention.
👉 Read the full article on Healthcare Business Today:
https://www.healthcarebusinesstoday.com/denied-claims-healthcare-revenue-crisis/
