Perspectives on AI, Denial Prevention, Revenue Cycle

CEO Perspectives: Health Systems Are Wrong About Their Denial Rates

I don’t mean that to be provocative, I mean it literally. The number any given hospital revenue cycle team reports as its denial rate is almost certainly not its denial rate. Upstream Revenue Loss Most health systems measure denials through...

April 24, 2026

Score First, Outsource Second: Why A/R Scoring Is the Smarter Path to Vendor ROI

Claim Denials Denials Revenue Cycle Optimization

Score First, Outsource Second: Why A/R Scoring Is the Smarter Path to Vendor ROI

Dollar value and recovery probability are not the same thing. Health systems that outsource without scoring first are paying contingency fees on claims they could have kept. For most health systems, accounts receivable outsourcing feels like a necessary hedge against...

April 22, 2026

Another way your 835 isn’t showing your denials.

Denials Revenue Cycle Analytics

Another way your 835 isn’t showing your denials.

The Loop 2110 segment was designed to communicate payer decisions. But payers have moved on, and health systems still managing denials through the remittance file are working with an incomplete picture. We’ve seen an influx of Google searches for “835...

April 15, 2026

Aetna’s SOI policy is changing inpatient reimbursement without showing up as a denial.

Claim Denials Revenue Cycle Analytics

Aetna’s SOI policy is changing inpatient reimbursement without showing up as a denial.

Last week, we wrote about PLBs and how revenue is being pulled back after payment in ways most teams aren’t actively monitoring. We’re also seeing a similar dynamic show up earlier in the process. Aetna’s SOI-based inpatient policy approves stays...

April 8, 2026

Most providers aren’t monitoring PLBs. Payers know it.

Denials Revenue Cycle Optimization

Most providers aren’t monitoring PLBs. Payers know it.

PLB data is rich in information, telling you which payers are recouping, how often, and in what patterns. But you won't see it in static retrospective RCM reports or standard denial dashboards. If your team isn't actively monitoring PLB activity...

March 31, 2026

Claim Denials Denials

Your Denials Team Is Under-Informed…

Day-in and day-out most denials teams are making high-stakes decisions with low-grade information.

March 16, 2026

Sift’s Fourth Annual Denials Insights Report

Revenue Cycle Optimization

Sift’s Fourth Annual Denials Insights Report

Sift Healthcare's Fourth Annual Denials Insights Report analyzes 2025 payer behavior trends and how they are reshaping the way health systems measure reimbursement risk.

March 9, 2026

Revenue Cycle Optimization

Adverse Payment Outcomes

Revenue cycle teams spend enormous energy managing denials, yet health systems still lose revenue. Here’s the case for a broader approach.

February 11, 2026

An Expanded Partnership With Hartford HealthCare

Denials

An Expanded Partnership With Hartford HealthCare

Sift Healthcare’s expanded partnership with Hartford HealthCare reflects a shared conviction that healthcare’s denial problem is the result of a clinical-financial intelligence problem.

February 11, 2026

AI Works

AI Works at Sift: Human Judgment in the Loop

Inside Sift Healthcare's AI Works program, thoughtful GenAI adoption, real AI use cases, and the human judgment layer that keeps our work meaningful.

November 4, 2025

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Sift Perspectives

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CEO Perspectives: Health Systems Are Wrong About Their Denial Rates

Score First, Outsource Second: Why A/R Scoring Is the Smarter Path to Vendor ROI

Another way your 835 isn’t showing your denials.

Aetna’s SOI policy is changing inpatient reimbursement without showing up as a denial.

Most providers aren’t monitoring PLBs. Payers know it.

Your Denials Team Is Under-Informed…

Sift’s Fourth Annual Denials Insights Report

Adverse Payment Outcomes

An Expanded Partnership With Hartford HealthCare

AI Works at Sift: Human Judgment in the Loop

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CEO Perspectives: Health Systems Are Wrong About Their Denial Rates

Score First, Outsource Second: Why A/R Scoring Is the Smarter Path to Vendor ROI

Another way your 835 isn’t showing your denials.

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Prevent costly denials while making your CDI, coding, and UR workflows more efficient and connected.

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CEO Perspectives: Health Systems Are Wrong About Their Denial Rates

Score First, Outsource Second: Why A/R Scoring Is the Smarter Path to Vendor ROI

Another way your 835 isn’t showing your denials.

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Social Links

Quick Links

Explore

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