by Aspirion | Apr 7, 2026 | Revenue Cycle Management, Veterans Affairs - TRICARE
In Veterans Affairs claims management, few requirements carry more financial weight than a single 72-hour window. Miss it, and a legitimate claim can be denied outright. For hospitals already stretched thin managing complex VA regulations, that’s not just an...
by Aspirion | Apr 1, 2026 | Payment Variance Recovery, Revenue Cycle Management, Zero-Balance Review
Aetna’s Level-of-Severity Inpatient Payment Policy creates a clear and appealable pathway for hospitals to challenge underpaid inpatient claims. At its core, the issue is straightforward: once Aetna approves an admission as inpatient, medical necessity is established,...
by Aspirion | Mar 30, 2026 | Artificial Intelligence (AI), Denials Management, Revenue Cycle Management
Published by Becker’s Healthcare, March 2026 | Author: Aspirion The Real Source of Rising Denial Rates Despite investments in Clinical Documentation Improvement programs, clinical denial rates keep climbing—not because of documentation failures, but because...
by Aspirion | Mar 18, 2026 | Artificial Intelligence (AI), Payment Variance Recovery, Revenue Cycle Management, Zero-Balance Review
Hospitals spend enormous energy chasing high-dollar denials. It makes intuitive sense—focus where the money is biggest. But this approach leaves a significant and largely invisible problem unaddressed: the accumulating weight of smaller denied claims that never get...
by Aspirion | Mar 4, 2026 | Artificial Intelligence (AI), Payment Variance Recovery, Revenue Cycle Management, Zero-Balance Review
Hospitals operate on razor-thin margins. For some health systems across the country, net margins hover below 5%—meaning every dollar of revenue carries significant weight. So when industry data suggests that a structured zero-balance review program can recover up...
by Aspirion | Feb 25, 2026 | Legislation, Motor Vehicle Accident, Revenue Cycle Management
By Martin Drake, Deputy General Counsel, Aspirion A quiet but significant legal shift is reshaping how hospitals get paid for treating motor vehicle accident (MVA) patients. Across the country, state legislatures are reworking the rules around what medical expenses...
by Aspirion | Feb 18, 2026 | Legislation, Out-of-Network Recovery, Revenue Cycle Management
Correction (Feb. 27, 2026): An earlier version of this article stated: “The Third Circuit ruled that arbitrators must presume the QPA is the appropriate payment unless other factors clearly outweigh it. Meanwhile, the D.C. Circuit rejected giving the QPA such...
by Aspirion | Feb 4, 2026 | Artificial Intelligence (AI), Denials Management, Revenue Cycle Management
If you ask many revenue cycle leaders what is driving denials, most will point to the usual suspects: coding errors, eligibility mix-ups, missing documentation. And they are not wrong—those issues are real, persistent, and costly. But they are not the whole story. A...
by Aspirion | Jan 28, 2026 | Artificial Intelligence (AI), Denials Management
Revenue Integrity DocIQ The AI Powering Our Denials Management Services Download Service Summary Aspirion's Services Meet DocIQ Payers accelerate denials with AI. Limited staff can’t keep pace—millions in revenue go unpursued. The solution. Our Denials...
