Revenue Cycle Analytics Archives - Sift Healthcare

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
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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
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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
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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
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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
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5 Levels of Denial Reporting — And Why Most Health Systems Stop at 3

Your EHR denial reporting probably answers these questions well: How many accounts did each rep touch? Which queues are aging? What’s your denial rate by payer? Those are legitimate operational questions. But they’re activity questions, and activity isn’t outcome. The...

Published on: May 21, 2026
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6 Things Aetna’s SOI Policy Is Breaking In Your Revenue Cycle

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.

Published on: May 4, 2026
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How to Know if a Denial Cluster is Worth Automating with an AI Agent

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...

Published on: April 30, 2026
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Segment Loop 2110: Another Way Your 835 Isn’t Showing Your Denials

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.

Published on: April 15, 2026
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Aetna’s SOI policy is changing inpatient reimbursement without showing up as a denial.

Last week, we wrote about PLBs and how revenue is being pulled back after payment in ways most teams aren’t actively monitoring.

Published on: April 8, 2026
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