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How MediMobile Tackles the Top 5 Healthcare Claim Denial Trends

Written by The MediMobile Team | May 14, 2025 7:32:42 PM

How MediMobile’s Genesis Platform Tackles the Top 5 Healthcare Claim Denial Trends from 2024

Healthcare organizations are under more pressure than ever to address rising claim denials. With payors deploying AI and intensifying scrutiny, providers need smarter, more scalable solutions. At MediMobile, we’ve spent over 20 years developing technologies that not only simplify clinical workflows but also strengthen revenue integrity at its core.

Here’s how our Genesis automated medical coding solution, along with our broader MediMobile platform, directly addresses the 5 major trends highlighted in MDaudit’s latest article:

 

  • Rise of AI in Claim Denial Management

MDaudit Takeaway: Payors are using AI to detect claim inconsistencies—providers must keep up.

How MediMobile Helps:

Genesis leverages deep learning and natural language processing to automatically generate CPT, ICD-10, and MIPS codes from clinical documentation—minimizing human error and proactively aligning charges to payer requirements. Our AI continuously learns from feedback, meaning the system gets smarter over time, reducing denial risk before submission.


  • Prior Authorization Challenges

MDaudit Takeaway: Even pre-approved services are getting denied.

How MediMobile Helps:

While Genesis focuses on coding and charge capture, MediMobile’s real-time data integrations (including ADT and MDM feeds) ensure providers have access to up-to-date patient, payer, and authorization data at the point of documentation. This empowers clinicians to confirm eligibility, authorization status, and payer rules at the time of care—reducing surprises down the line.

  • High-Cost Claim Denials

MDaudit Takeaway: Expensive claims face higher scrutiny.

How MediMobile Helps:

Genesis promotes accuracy and specificity in coding complex conditions and treatments. It includes logic for suggesting appropriate levels of Medical Decision Making (MDM), preventing overcoding or undercoding—common issues with high-cost services. Charge Review workflows allow billing staff to flag and verify high-risk encounters before submission.

 



  • Compliance with Regulatory Changes and Scrutiny

MDaudit Takeaway: Scrutiny is increasing for specific conditions like sepsis and diabetes drugs.

How MediMobile Helps:

Genesis is continuously updated to reflect the latest regulatory changes and payer policies. It flags common audit targets and ensures clinicians document the necessary details to justify their coding decisions. Combined with our audit tracking features and analytics dashboards, compliance teams can quickly spot trends and maintain control.



  • Documentation and Coding Errors

MDaudit Takeaway: Errors remain the leading cause of denials.

How MediMobile Helps:

Genesis eliminates manual entry by transforming the physician's note directly into billable codes in real time. With customizable coding logic, built-in guardrails, and our Charge Integrity feature, we ensure no unbilled patients or encounters slip through the cracks. This dramatically increases first-pass accuracy and reduces rework.


 

Denial Prevention Starts With Automation

MDaudit is right—overturning denials is expensive. The real win is preventing them in the first place. MediMobile’s Genesis platform was built to do just that. From automated coding and documentation support to integrated charge review and analytics, we make sure your revenue cycle is protected from the inside out.

Let’s stop chasing denials—and start capturing revenue correctly the first time.

 

Book a demo on our calendar below to see how Genesis can transform your approach to denial prevention.