top of page


A VP of Revenue Cycle's Strategic Guide to DRG Downgrades
Payer AI systems are processing audits 24/7, targeting high-value DRGs like sepsis and respiratory failure. Learn how revenue cycle leaders are fighting back with AI-powered appeal workflows that reduce processing time by 80-90%, increase appeal volume 3-4x, and turn audits into competitive advantages. Discover implementation strategies, key metrics, and ROI frameworks to modernize your denial management program.
Adi Tantravahi
Jun 4, 20258 min read


When Algorithms Decide Who Lives and Who Suffers
AI-powered claim denials are transforming healthcare, but at what cost? Examine the controversies around automated coverage decisions, alleged high error rates, and the tension between cost management and patient care. Learn about emerging state regulations, provider response strategies using counter-AI, and the broader policy debate over healthcare as market commodity versus public good. What comes next for the industry?
Adi Tantravahi
Jan 14, 20254 min read
bottom of page