Oran Lopez Reed

Observations from the conference floor, minus the vendor hype

Nearly 15% of all healthcare claims submitted to payers for reimbursement are initially denied, with more than half eventually overturned...

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...