Скачать или смотреть Why 11.8% of Your Claims Get Denied (It's Not Your Billing Team's Fault)

One in eight claims your practice submits will get denied on the first try.

That's the industry average according to MGMA—11.8% of your revenue stuck in limbo before you ever see it.

The standard advice is always the same.

Hire another biller.

Train your staff.

Appeal faster.

Work the denials harder.

But that advice misses the point entirely.

Most claim denials don't originate in billing.

They originate upstream—at check-in, during scheduling, in the exam room.

Eligibility that wasn't verified. Prior authorizations that were never flagged.

Documentation that came through incomplete or inconsistent.

Patient demographics that don't match what the payer has on file.

By the time your billing team sees the claim, it's already broken.

They're not preventing denials—they're chasing them.

And that rework is expensive.

The Medical Group Management Association estimates it costs $25 to $118 to rework a single denied claim.

Multiply that across hundreds of denials per month and you're burning staff hours and cash on problems that could have been prevented.

That's exactly why we built Caesar Health to work upstream.

Our AI agents verify eligibility before patients arrive, flag missing authorizations in real time, and help ensure documentation is complete before anything is submitted.

Clean claims from the start. Fewer denials. Faster revenue.

If your practice is stuck in the denial-and-rework cycle, let's talk.

Comment below with what's causing the most friction, or visit caesarhealth.com.

#medicalbilling #claimdenials #revenuecyclemanagement #healthcareai #practicemanagement