Oran Lopez Reed

HFMA 2025 revealed that even leading health systems like UC San Diego Health are missing 47% of mission-critical RCM technologies. Learn what actually works in autonomous coding, denial management, and AI implementation, beyond vendor hype. Discover why development partnerships outperform product purchases, realistic timelines for technology adoption, and actionable strategies for academic, community, and rural hospitals.

Stop losing revenue to inpatient vs. observation status denials. AI-powered utilization review helps hospitals correctly classify patients, reduce claim denials, and cut appeal time from hours to minutes. Learn implementation strategies, key performance metrics, and how leading healthcare organizations use AI to strengthen UR processes, improve documentation, and recover more revenue through successful appeals.

Nearly three in four healthcare providers report that insurance claim denials have increased between 2022 and 2024, with approximately 38% of survey respondents indicating that at least one in ten claims are denied ( Experian Health, 2024 ). Among these denials, those based on medical necessity represent a significant and persistent challenge for healthcare organizations, adding administrative burden and threatening financial stability. Understanding Medical Necessity Denials Medical...