News Alert: A Historic Surge in Denials and Audits

A recent analysis of 5 billion claims from a sampling of providers found that total at-risk dollars from payer audits were five times higher in 2024 than in 2023 – $ 11.2 million, versus $2.6 million – while coding-related denials surged by more than 125 percent and clinical documentation audits and reviews were up 100 percent.

These and other findings were reported earlier today on Monitor Mondays by Ritesh Ramesh, who was the special guest during the live weekly Internet broadcast. Ramesh, the CEO for MDaudit, who made the announcement, was reporting from a newly released MDaudit 2024 Benchmark Report.

Ramesh said the “unsettling findings” indicate that 2025 will be another challenging year for healthcare finance leaders.

MDaudit is a provider of technologies and analytics tools that enable premier healthcare organizations – including more than 70 of the nation’s top 100 health systems, with $1 billion in net patient revenue – to minimize billing risk and maximize revenues.

He holds an MBA from MIT Sloan School of Management and an MS in Computer Science from the Illinois Institute of Technology.