Where Denials Go to Die

The 3-step loop that turns denials into clean claims

Author

Dino Gane-Palmer
August 12, 2025

Hi and happy Tuesday,

During a review with a multi‑site clinic two weeks ago, one report froze the room. Dozens of claims sat in the denial queue, and someone finally asked:

 “How many of these will ever turn into cash?”

Their initial denial rate was nearly 12%, in line with the national average. Most would eventually be paid, but only after weeks of rework and delayed cash flow. 

How clean are your claims?

Out of every 100 claims you submit, how many get paid without a single denial? (We'll share the survey results in our next newsletter)

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We introduced a simple 3‑step loop that consistently turns denials into clean claims and prevents repeat errors.

Step 1: Triage fast

Review every denial within 48 hours and classify by root cause: intake errors, missing documentation, or payer disputes. 

Route each to the person who can actually fix it.

Metric: Initial vs. final denial rate and median days to resubmission.

Pro tip: Correct intake errors first. Preventable denials disappear the next time those claims are submitted.

Step 2: Convert with precision

Keep a one‑page guide for each payer with the top denial reasons and their fixes. When a claim is denied, make all corrections once and resubmit it clean.

Metric: First‑pass yield on resubmitted claims. Hitting 90% shows your edits are effective.

Pro tip: Focus your effort on denials where your data shows the best chance of recovery.

Step 3: Feed the system

Each week, push at least two fixes upstream: an intake prompt, a coding rule, or a PA reminder. Then, share a brief “what changed and why” with the team.

Metric: Track how often the last cycle’s top 3 denial reasons appear again. A drop shows your fixes are working.

Pro tip: The biggest win is when a denial reason disappears completely.

Quick self‑check:

  1. What percentage of denials are resubmitted within 5 business days?

  2. Which three denial reasons repeat most often, and how have you fixed them upstream?

  3. Is your appeal win rate high enough to justify the cost of rework?

Want to know how AI fits in your RCM workflow?

With Auxee, teams are reducing denials, speeding up payments, and finally getting ahead of payer changes, without changing their systems or retraining their staff.

See how Auxee works, read the case study or watch a 96-second demo to learn what’s working in the field.

You can also book a quick demo to get your questions answered, or take our RCM blindspot assessment to see where your practice is losing and how to plug the leaks.

Next week, I’ll cover the three levers that move cash velocity and show you how to build a simple dashboard to track them.

See you next Tuesday,
Dino Gane-Palmer

That's it for today!

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Dino Gane-Palmer
[email protected]

About the Author

Dino Gane-Palmer is the founder of Auxee and CEO of PreScouter, an Inc. 5000–recognized innovation consultancy that helps Fortune 500 companies and global organizations capitalize on new markets and emerging technologies. He launched PreScouter while earning his MBA at Kellogg and later founded Auxee to help teams use AI to tackle complex, research-heavy workflows. His work has supported decisions at some of the world’s leading healthcare, manufacturing, and consumer brands. Dino is also the author of the best-selling book Do More With Less: The AI Playbook, a practical guide to applying AI where it matters most.