Marcus Treadwell

Automation handles billing's high-volume tasks, but human expertise must govern its limits.

Payers are quietly underpaying claims without triggering denial codes or alerts.

Rule-based scrubbing catches structural errors, but AI learns what actually causes denials.

Credentialing delays create permanent revenue losses that standard billing checks cannot detect.

How three denial types—order disputes, stale coverage data, and payer errors—stall most COB claims.

Bouncebacks halt claims before adjudication; denials require appeals after payer review.

Programs exempt top providers from prior auth requests but face gaps in real-world implementation.

Wide variations in denial rates among insurers reflect policy choices, not clinical necessity.

Delays in processing denials cost more money than the denials themselves.