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NexaClaim Insights

Expert analysis on denial management, AI in healthcare, payer intelligence, and revenue cycle strategy — written by RCM practitioners.

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Denial Management

Featured

Why 63% of Medical Claim Denials Are Never Appealed (And What It's Costing You)

The U.S. healthcare system loses $262 billion annually to denied claims — but the real scandal is that nearly two-thirds of those denials are never challenged. Here is the math behind the crisis and a 5-step framework to fix it.

Dr. Maria Chen

VP of Clinical Revenue

Mar 18, 20269 min readRead Article

All Articles

Prior Authorization

The Hidden Cost of Prior Authorization: A CFO's Guide to $13B in Administrative Waste

Prior authorization consumes 40 minutes of physician time per request and generates $13 billion in annual administrative waste. Here is the CFO-level breakdown of the true cost burden and the ROI case for AI-powered automation.

James Park

Mar 14, 2026·10 min

AI in RCM

GPT-4o vs. Traditional Clinical NLP: What Actually Works for Medical Coding in 2026

Rule-based coding engines dominated RCM for two decades. Large language models are now outperforming them on complex cases — but the story is nuanced. Here is a rigorous comparison of accuracy, confidence scoring, and when AI should defer to human coders.

Sarah Kim

Mar 10, 2026·12 min

Payer Intelligence

Payer Scorecard Report 2026: Which Insurers Have the Highest Denial Rates?

Our analysis of denial rates across major payer categories reveals significant variation — and actionable intelligence for proactive denial prevention. Medicare Advantage leads at 13.1%, while Workers' Comp hits 15.3% in high-complexity specialties.

Revenue Cycle Analytics Team

Mar 5, 2026·8 min

Revenue Cycle

The True Cost of Claim Denials in 2026

Denied claims cost the U.S. healthcare system over $262 billion annually. We break down where the money goes, which denial types are most costly, and what organizations can do to stem the losses.

NexaClaim Editorial Team

Mar 15, 2026·8 min

AI in RCM

How AI is Transforming Revenue Cycle Management

From denial prediction to automated appeals, AI is reshaping every stage of the revenue cycle. Here is what the technology can and cannot do today, and where it is heading in the next 12 months.

Sarah Kim

Mar 10, 2026·10 min

Denial Management

5 Strategies to Reduce Your Denial Rate by 50%

Practical, proven strategies that mid-market healthcare organizations are using to cut their denial rates in half within 6 months. No massive team required.

Dr. Maria Chen

Mar 5, 2026·6 min

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