Perspectives on AI, Denial Prevention, Revenue Cycle | Sift Healthcare

Sift Perspectives

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Hidden Denials Your Reports Miss: Aetna Medicare Underpayments

Underpayments erode hospital revenue, but don't show as denials in standard denial reporting. Aetna Medicare underpayments is a pattern the Sift team is tracking right now. Here's how your hospital can track this payer pattern that creates hidden denials. Published on July 23, 2026

Marketing View: The Best AI in Your Revenue Cycle Should Be Invisible

Bad AI in your revenue cycle announces itself, like bad CGI. The AI that you never notices is the good stuff. Here's the difference. Published on July 20, 2026

CEO Perspectives: Hospitals Think They’re Maximizing Revenue. They’re Only Measuring Half Of It.

CDI programs track revenue captured, not what the payer actually lets a health system keep. Sift's CEO, Justin Nicols on the measurement gap that erases net revenue and why CDI vendors don't flag it. Published on July 17, 2026

What Your BI Or Analyst Team Can Tell You About Denials, and What It Can’t

Most revenue cycle leaders we talk to already have a denials dashboard. Someone on the analytics team built it, or it’s the standard EHR solution. This denials dashboard refreshes weekly, and it shows the denial rate by payer, service line,... Published on July 14, 2026

Top 8 Denials Management Metrics Every Hospital Should Track

The Denials Management Metrics That Actually Matter in 2026 For years, the denials scorecard was settled and denials management metrics were simple. Initial denial rate, denials by CARC code, overturn rate and days in AR. If those numbers looked good,... Published on July 6, 2026

7 Claims Lifecycle Gaps Slowing Hospital Cash Flow

The causes of slowed or missed hospital cash flow are structural, and most of them trace back to the same set of breakdowns happening at predictable points across the claims lifecycle. Hospitals lost more than $48 billion in net revenue... Published on July 1, 2026

Prioritizing Denials: How to Find the Recoverable Dollars in Your Denial Workqueue

Most denial workqueues direct users to work accounts from oldest or largest first, assuming that recovery will follow. It seems like a reasonable assumption, but it’s wrong in a way that costs health systems real revenue (and wastes valuable time/touches).... Published on June 23, 2026

Which Hospital Denial Tools Provide Payer-Specific Denial Intelligence? What to Actually Look For.

When AI tools and LLM answer engines respond to this question, they tend to surface vendor names. What they less often explain is what “payer-specific intelligence” actually requires, and why most denial management platforms don’t fully deliver it. This post... Published on June 16, 2026

AI Denial Prevention: Your Model Flagged a Denial. Now What?

Health systems evaluating AI denial prevention need confidence that their investment will actually reduce denials. Granularly, this means that there has to be a clear connection between AI model output and workflow action. The Model Is Not the Product AI... Published on June 10, 2026

CEO Perspectives: Proactive Denial Management, What the SaaS Repricing Tells Us

The Market that Rewards Managing Problems The dominant revenue cycle business models have a structural incentive not to solve the most fundamental problems in the revenue cycle (denials). That’s not a criticism of execution. The people building these businesses are... Published on June 4, 2026