## Category: Denials

#### [6 Things Aetna’s SOI Policy Is Breaking In Your Revenue Cycle](/content/sift-perspectives/aetna-medicare-soi-policy-impact/index.html)

Last month, we wrote about the updated Aetna Medicare SOI policy and what it means for inpatient reimbursement. Since then, we’ve been watching how this plays out operationally, and the picture is more complicated than the policy summary suggested. What...

[May 4, 2026](/content/sift-perspectives/aetna-medicare-soi-policy-impact/index.html)

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#### [How to Know if a Denial Cluster is Worth Automating with an AI Agent](/content/sift-perspectives/how-to-know-if-a-denial-cluster-is-worth-automating-with-an-ai-agent/index.html)

Agentic AI is being hailed across the revenue cycle right now, for appeals, claim resubmissions, documentation retrieval and a slew of other workflows. For the most part, the use cases make sense on paper. But many health system revenue cycle teams are making deployment decisions based on...

[April 30, 2026](/content/sift-perspectives/how-to-know-if-a-denial-cluster-is-worth-automating-with-an-ai-agent/index.html)

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#### [CEO Perspectives: Health Systems Are Wrong About Their Denial Rates](/content/sift-perspectives/wrong-about-denial-rates/index.html)

I don’t mean that to be provocative, I mean it literally. The number any given hospital revenue cycle team reports as its denial rate is almost certainly not its denial rate. Upstream Revenue Loss Most health systems measure denials through...

[April 24, 2026](/content/sift-perspectives/wrong-about-denial-rates/index.html)

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#### [Score First, Outsource Second: Why A/R Scoring is the Smarter Path to RCM Vendor ROI](/content/sift-perspectives/denial-scoring-outsourcing/index.html)

Dollar value and recovery probability are not the same thing. Health systems that outsource without scoring first are paying contingency fees on claims they could have kept. For most health systems, accounts receivable outsourcing feels like a necessary hedge against...

[April 22, 2026](/content/sift-perspectives/denial-scoring-outsourcing/index.html)

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#### [Segment Loop 2110: Another Way Your 835 Isn’t Showing Your Denials](/content/sift-perspectives/segment-loop-2110/index.html)

The Loop 2110 segment was designed to communicate payer decisions. But payers have moved on, and health systems still managing denials through the remittance file are working with an incomplete picture. We’ve seen an influx of Google searches for “835...

[April 15, 2026](/content/sift-perspectives/segment-loop-2110/index.html)

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#### [Most providers aren’t monitoring PLBs. Payers know it.](/content/sift-perspectives/monitoring-provider-level-adjustments/index.html)

PLB data is rich in information, telling you which payers are recouping, how often, and in what patterns. But you won't see it in static retrospective RCM reports or standard denial dashboards. If your team isn't actively monitoring PLB activity...

[March 31, 2026](/content/sift-perspectives/monitoring-provider-level-adjustments/index.html)

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#### [Your Denials Team Is Under-Informed…](/content/sift-perspectives/your-denials-team-is-under-informed/index.html)

Day-in and day-out most denials teams are making high-stakes decisions with low-grade information.

[March 16, 2026](/content/sift-perspectives/your-denials-team-is-under-informed/index.html)

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#### [An Expanded Partnership With Hartford HealthCare](/content/sift-perspectives/an-expanded-partnership-with-hartford-healthcare/index.html)

Sift Healthcare’s expanded partnership with Hartford HealthCare reflects a shared conviction that healthcare’s denial problem is the result of a clinical-financial intelligence problem.

[February 11, 2026](/content/sift-perspectives/an-expanded-partnership-with-hartford-healthcare/index.html)

[Read more](/content/sift-perspectives/an-expanded-partnership-with-hartford-healthcare/index.html)