October 28, 2026 Tony Terranova Reimagined Health
Denials get the attention in revenue cycle management, and for good reason. Nearly 15% of claims to private payers are denied on first submission, according to a 2024 Premier survey, and more than half of those are eventually paid once someone pursues them.
But denials are the leaks you can see. They come back with a reason code and land in a work queue.
For growing, multi-site health organizations, the more expensive losses are often the ones that never generate a denial at all. A claim that is never sent, or is sent for less than it should be, doesn't trigger an alert. It just shows up months later as a quarter that came in a little light.
Three quiet leaks
1. Master data drift
Organizations that grow by acquisition inherit a copy of everything with each new clinic: payers, plans, providers, locations, and service definitions, often across more than one EHR. Over time those copies drift apart.
The consequences are rarely dramatic. A front-desk team renames a payer, and claims tied to the old name stop routing. A new provider's credentials are recorded differently at two sites, and charges get built at the wrong level. Nobody sees an error. The clinic's revenue simply dips, and it can take weeks to trace why.
2. Under-coding
Many payers reward a set of services delivered together with a single bundled code worth more than the services billed one by one. Billing systems built for simple fee-for-service logic can't check whether a bundle was earned. So they bill line by line.
Consider an illustrative week of care that qualifies for a $200 bundled code. Billed item by item, the same week might bring in $160. Nothing is denied and nothing is flagged, but roughly 20% of earned revenue disappears on every qualifying week, at every site.
3. Eligibility found too late
When coverage and authorization are verified inconsistently, or only after a claim comes back, organizations pay twice: once in the denial, and again in the staff time to rework it. Premier puts the average cost of fighting a single denial at $43.84. For patients seen frequently, coverage can change between visits, so a check at intake alone isn't enough.
Where to start
These leaks share a root cause: billing systems designed for one provider at one site, building one claim at a time, applied to organizations that look nothing like that. Adding billers treats the symptom. The fix is upstream.
You don't need to rebuild your revenue cycle to find out what's at stake. Three focused moves usually surface a dollar figure within weeks:
1. Reconcile master data across sites. Compare payer, plan, provider, and service records across every location and EHR. Mismatches point directly at claims that are routing incorrectly or not at all.
2. Run an eligibility sweep. Verify coverage for all active patients at once, rather than waiting for denials to reveal the gaps.
3. Audit your highest-volume services for missed bundles. Check whether services that qualify for bundled or higher-value codes are being billed individually instead.
Each one produces a number leadership can act on, and together they show whether the problem is a few clinics or the whole system.
The revenue you've already earned
The most valuable revenue cycle improvement is rarely a new source of revenue. It's collecting what your teams have already delivered care for. For organizations growing across sites and systems, that starts with seeing the leaks that never announce themselves.
Ready to see where your revenue cycle stands? Reimagined Health helps multi-site health organizations unify their data and close the gap between care delivered and revenue collected. Get in touch to start the conversation.