Tackling Rising Denials and Coding Challenges: How Hospitals Can Protect Their Revenue

Hospitals and provider groups are under constant pressure to keep revenue flowing. But with denial rates climbing, coding requirements tightening, and staffing shortages growing, revenue leakage has become a daily reality. Each denied claim or coding error means lost dollars and wasted effort.

This blog highlights the latest challenges in coding and revenue cycle management (RCM) - and how RevSync Healthcare can help hospitals solve these issues efficiently and cost-effectively.

Why Denials and Coding Issues Are Getting Worse

1. Denial Rates Are Rising: Payers are scrutinizing claims more closely than ever. In 2025, industry data shows denial rates hovering at 11–12%, with common causes including incomplete documentation, incorrect coding, and missing prior authorizations.

2. Staff Shortages and Burnout: Certified coders and HIM professionals are in short supply. Hospitals often face gaps in specialized coding expertise, leading to backlogs and delays in claim submission.

3. Documentation Gaps: When clinical documentation doesn’t fully support the services delivered, coding accuracy suffers. This mismatch increases the likelihood of denials and lost reimbursement.

4. Constantly Changing Rules: ICD-10 updates, payer-specific requirements, and stricter compliance standards make it harder for internal teams to keep up.

The Cost of Inaction

• Lost revenue: Services may never be reimbursed if claims are denied or under-coded.

• Cash flow delays: Payment cycles stretch longer as teams chase denials and appeals.

• Compliance risk: Coding errors expose hospitals to audits and penalties.

• Staff stress: Teams spend more time reworking claims than improving processes.

How RevSync Healthcare Solves These Challenges: At RevSync, we act as your extended RCM and HIM team. Here’s how we help:

• Certified Coding Support: Experienced coders across all specialties ensure claims are clean, compliant, and accurate.

• Denial Prevention & Appeals: We identify denial patterns, resolve root causes, and manage appeals efficiently.

• Charge Capture Optimization: Our team ensures all billable services are documented and charged correctly.

• Flexible Resourcing: We scale with your needs - providing overflow support or dedicated expertise without adding full-time overhead.

• Analytics & Compliance Monitoring: We track KPIs like denial rates and AR days, helping you stay ahead of risks.

Cost-Effective Partnership: Instead of hiring, training, and retaining large in-house teams, hospitals can leverage RevSync’s expertise on-demand. This reduces fixed costs, accelerates cash flow, and keeps revenue secure.

Denials and coding challenges aren’t going away - but they don’t have to drain your revenue either. With RevSync Healthcare as your partner, you can reduce denials, optimize coding, and stop revenue leakage.

Contact RevSync today to request a free revenue cycle assessment. info@revsynchealthcare.com