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Updated: July 20, 2026 by ahmad 8 min read November 26, 2025

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Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy.Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy.Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy.Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy.Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy.

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August 26, 2026 by Adam Lewis

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Sed egestas malesuada pharetra. Donec nec sapien venenatis, consectetur dui vel, molestie sapien. Donec ac tortor est. Nam mattis nec massa quis volutpat. Nulla ac dictum nulla, volutpat placerat dui. Phasellus ac lacus quis est ultrices suscipit semper quis lorem. Sed ultrices tincidunt pharetra. Integer tempus nisi eu dolor varius dapibus. Ut scelerisque, justo quis pulvinar dapibus, dui augue fermentum dui, imperdiet commodo neque nisl ullamcorper augue. Nam lacinia arcu vel dolor bibendum, quis tempor elit luctus. Cras et lectus tempus, ullamcorper magna at, sodales diam. Morbi a fermentum magna. Donec id placerat felis. Phasellus imperdiet turpis ullamcorper scelerisque molestie. Phasellus tincidunt mattis enim, ac ullamcorper nulla sodales nec. Proin tincidunt velit interdum finibus vehicula. Vivamus dui tortor, vestibulum vel faucibus id, feugiat et felis. Suspendisse a massa mi. Maecenas mollis, nibh at porttitor volutpat, sapien augue lacinia lorem, et euismod ipsum lacus non augue. Integer vestibulum nunc non quam egestas, et malesuada est laoreet. Curabitur aliquam sodales ipsum a dictum. Fusce tincidunt quis tellus et auctor. Maecenas eu dapibus libero. Donec pellentesque turpis augue, vitae condimentum enim maximus eu. Ut tempus aliquam sem ut sodales. Quisque ipsum lectus, sollicitudin eget porta eu, semper a magna. Quisque dolor mi, tempor at dui quis, aliquam sagittis lacus. Aenean tempus, augue eu consectetur consectetur, eros enim sodales risus, sit amet porttitor libero nunc vel massa. Vestibulum eleifend viverra nisi, quis lacinia enim auctor ac. Mauris nisl mi, consequat a mi sed, accumsan iaculis augue. Nam sodales neque eget metus volutpat sodales. Praesent tempus ex neque, id pellentesque nibh elementum ac. Donec suscipit posuere hendrerit. Etiam finibus justo vel neque porta pretium. 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Personal credit report assistance is not available here. If you have questions or issues related to your personal credit report, disputes or fraud alerts, visit Experian.com/help. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Sed egestas malesuada pharetra. Donec nec sapien venenatis, consectetur dui vel, molestie sapien. Donec ac tortor est. Nam mattis nec massa quis volutpat. Nulla ac dictum nulla, volutpat placerat dui. Phasellus ac lacus quis est ultrices suscipit semper quis lorem. Sed ultrices tincidunt pharetra. Integer tempus nisi eu dolor varius dapibus. Ut scelerisque, justo quis pulvinar dapibus, dui augue fermentum dui, imperdiet commodo neque nisl ullamcorper augue. Nam lacinia arcu vel dolor bibendum, quis tempor elit luctus. Cras et lectus tempus, ullamcorper magna at, sodales diam. Morbi a fermentum magna. Donec id placerat felis. Phasellus imperdiet turpis ullamcorper scelerisque molestie. Phasellus tincidunt mattis enim, ac ullamcorper nulla sodales nec. 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August 26, 2026 by Andy.Monte@experian.com

Why are healthcare claims denied? Even the smallest mistakes on claims submission can trigger denials. Nearly 70% of providers say submitting clean claims is harder than it was a year ago, and 54% report an increase in claim errors, according to Experian Health’s 2025 State of Claims report. Some common reasons for healthcare claims denials include: Incomplete registration records: 26% of providers report that at least 10% of denials stem from inaccurate or incomplete data collected during registration. Missing patient information: Incomplete or incorrect patient data collected at registration triggers 32% of claim denials, according to Experian Health’s latest State of Claims report. Inaccurate insurance data: Outdated patient insurance information, missing coverage or mistakes made when entering insurance data during registration can lead to rejected or denied claims. Eligibility verification errors: Mistakes during manual eligibility checks or incomplete insurance eligibility verification are common causes of denials. Prior authorization issues: 35% of claim denials are triggered when prior authorizations aren’t obtained or don’t fully meet prior authorization requirements before claims submission. Coding inaccuracies: Missing medical billing codes and coding errors account for 24% of denials. Nearly half of providers say that coding errors are one of the top three most preventable claims errors in the latest Experian Health Claim Denial Management survey. Coordination of benefits (COB) errors: Coordinating benefits across several payers is a complex process and mistakes that lead to denials are common, especially when COB is handled manually.

July 20, 2026 by Krishna Nelluri

Understanding contract management for healthcare Key takeaways: Contract management in healthcare is about negotiating, executing and monitoring agreements so providers can check that they are being paid in line with their contracts. Managing contracts across hundreds of payers and changing regulatory requirements is complex. Automation, AI and analytics can streamline contract oversight and identify discrepancies earlier. Tools such as Experian Health’s Contract Manager help providers audit payer performance, flag underpayments and manage contracts more efficiently across the contract lifecycle. The front-end data problem behind claim denials Experian Health surveyed 200 healthcare leaders from January to February 2026 to better understand the reasons for claim denials and opportunities for improvement. What are eligibility-related claim denials? Eligibility-related claim denials happen when a payer denies a claim submission for reimbursement due to patient insurance issues. Inaccurate or missing patient insurance information is a top denial trigger and often starts at the front end, during registration. Evolving payer eligibility requirements and new regulatory mandates also make it challenging for providers to avoid eligibility issues that can lead to denials. The most common causes of eligibility errors in healthcare billing 1. Mistakes made during patient intake: Eligibility-related issues often begin during patient intake – especially when providers use manual registration processes, like paper forms. Incorrect patient information entered on the front-end can cause eligibility issues that lead to billing mistakes, reimbursement issues and denials. Experian Health data shows that incomplete or missing insurance patient registration data is a top cause of claim denials, accounting for 32% of denials in 2025.

July 15, 2026 by Krishna Nelluri

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July 10, 2026 by Krishna Nelluri

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Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy.

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It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.

It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.

It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.

It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.

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It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.

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It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.

It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.

It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.

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Key takeaways: Revenue cycle teams can use automation to reduce repetitive work and apply AI where data-driven prediction, matching or prioritization can improve a workflow. Experian Health’s 2025 State of Claims survey found that 41% of providers now face denial rates of 10% or higher, while 68% say submitting clean claims is more challenging than a year ago. Patient Access Curator™ (PAC) uses AI to support front-end data validation and insurance discovery, while AI Advantage™ helps teams predict denial risk and prioritize denial follow-up. Artificial intelligence (AI) and automation can support administrative work in healthcare. In the revenue cycle, teams depend on accurate information, timely decisions and efficient follow-up to keep claims moving. In revenue cycle management, AI and automation can help organizations reduce manual checks, find data gaps, predict denial risk and prioritize work queues. These tools are most useful when they support staff judgment, payer expertise and compliance oversight. They can handle repetitive, data-heavy tasks so staff can focus on exceptions and decisions that need human review. In 2023, McKinsey & Company reported that research suggests effectively deploying automation and analytics could eliminate $200 billion to $360 billion of spending in U.S. healthcare. For revenue cycle leaders, the practical question is where to apply those capabilities first. The case for applying AI and automation in healthcare Revenue cycle teams juggle many daily tasks. Staff collect and verify patient information, confirm eligibility, identify the right payer, submit clean claims, monitor status, work denials and manage collections. Small data gaps at the beginning of the process can create downstream rework and delays. Rework also consumes staff time, adding to these operational pressures. As costs rise and revenue cycles tighten, there is increasing pressure to do more with less. Experian Health’s 2025 State of Claims survey found that 54% of providers say claim errors are increasing and 90% of claim denials are reworked with at least some human review before resubmission. Providers are also managing broader financial and administrative pressures. The American Hospital Association has reported that prior authorization requirements, claim audits, denials and other payer policies add administrative burden and cost for hospitals and health systems. These requirements also consume staff time to appeal denials and manage payer processes. AI and automation are different but complementary. Automation follows defined rules to complete repeatable work. AI models can identify patterns in data, predict risk and help teams decide where to focus attention. When used together, they can support more consistent revenue cycle workflows. How AI and automation can support revenue cycle workflows Revenue cycle management automation and AI are most useful when tied to a specific workflow and a measurable operational problem. The goal is to help teams act earlier, reduce avoidable rework and focus staff time where judgment is needed most. For example, automation can complete rule-based eligibility checks. AI can help identify claims with a higher likelihood of denial. In insurance discovery workflows, AI can also help identify coverage that wasn’t captured at registration. When these tools fit into existing workflows, they can support more consistent decisions and reduce manual work. Three practical applications include: 1. Improving front-end data quality with Patient Access Curator Patient and coverage information collected early in the revenue cycle can affect downstream claim outcomes. Incomplete or outdated demographic details, eligibility responses, coordination of benefits or Medicare Beneficiary Identifier information can create problems that lead to claim delays or denials later in the cycle. Experian Health’s Patient Access Curator helps prevent claim denials by validating demographics, eligibility, insurance discovery, coordination of benefits and Medicare Beneficiary Identifier data in seconds. PAC’s AI and machine learning capabilities help improve match accuracy, coverage sequencing and data confidence by writing the validated data back into the host system and sequencing payers before the claim is created. This automates work that would otherwise require manual coverage checks. 2. Using insurance discovery to find coverage not captured at registration When active coverage isn’t identified during registration, claims may be delayed or submitted with incomplete insurance information. Insurance discovery looks for coverage that may not have been captured during registration. Patient Access Curator includes insurance discovery as part of its front-end validation workflow. It can help identify and correct missing or incorrect insurance information so claims can be submitted with more complete coverage data. 3. Using AI to prevent and prioritize denials Even with strong front-end processes, some claims still require additional attention. AI can help claims teams decide which claims to review before submission and which denials to work first after payer response. Experian Health’s AI Advantage supports two denial management use cases:1. AI Advantage – Predictive Denials uses a client’s historical claims data and Experian’s knowledge of payer rules to identify claims with a high likelihood of denial before submission so teams can take corrective action.2. AI Advantage – Denial Triage uses AI to segment denials and identify those with the highest potential for reimbursement. This approach can help teams prioritize with more confidence. Rather than treating every claim or denial the same way, teams can use predictive models to focus on the work that needs the most attention. Potential benefits of AI and automation in the revenue cycle A high-performing revenue cycle depends on timely, accurate and consistent work. AI and automation can help providers modernize that work without losing the expertise of the people who manage complex payer and patient situations every day. When applied to the right workflows, these tools can help organizations: Reduce manual data searches that take staff away from higher-value work Improve front-end data quality before claims are created Identify missing or incorrect coverage information earlier Spot claims that may be at higher risk of denial Prioritize denied claims by potential reimbursement Reduce rework caused by inaccurate or incomplete information Give staff more consistent information for follow-up decisions A focused AI strategy starts with the workflow problem, uses data that is relevant to that problem and keeps staff in control of judgment-based decisions. A more proactive approach to revenue cycle management Revenue cycle teams can move from reactive work toward a more proactive approach: catch errors earlier, validate coverage before claims are created and prioritize the claims and denials that need the most attention. Experian Health offers revenue cycle solutions that use AI and automation in targeted ways to support front-end data quality, reduce rework and manage denials. Patient Access Curator supports registration and coverage validation, while AI Advantage supports denial prediction and triage. Learn more about Experian Health’s Patient Access Curator and AI Advantage.

October 2, 2026 by Andy.Monte@experian.com
Experian Health ranked #1 in Best in KLAS for 2025

Experian Health is very pleased to announce that we've ranked #1 in the 2025 Best in KLAS: Software & Services report, for our Contract Manager and Contract Analysis product, for the third consecutive year. Contract Manager, when paired with Contract Analysis, empowers healthcare providers by ensuring payers comply with contract terms, identifying and recovering underpayments, and arming them with real claims data to negotiate contracts. This enables providers to negotiate more favorable terms and maintain financial stability.  Clarissa Riggins, Chief Product Officer at Experian Health, says, “In the ever-evolving healthcare landscape, our Contract Manager solution has once again been recognized as the #1 Revenue Cycle Management tool by KLAS for the third consecutive year. This prestigious ranking underscores the significant value our solution delivers to our clients by identifying underpayments and facilitating revenue recovery. We are honored to continue supporting our clients with innovative solutions that drive financial success and operational efficiency.”  Learn more about how Contract Manager and Contract Analysis can help your healthcare organization validate reimbursement accuracy, recover underpayments and boost revenue.   Learn more Contact us

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