RCM Challenges: Denial Management

Matthew Bridge & Erica Franko

April 21, 2023

In the healthcare sector, it is becoming increasingly challenging for patients to receive insurance coverage for their services; payor denials are increasing. Oftentimes, insurance companies are deciding that certain services are not “medically necessary,” making it more difficult for patients to receive access to the care they need. In fact, in 2021, almost 17 percent of in-network healthcare claims were denied—that’s almost one in every five! And combatting an insurance denial is an extreme headache, so healthcare workers and patients don’t always fight back for coverage.

Why is there such a high number of payor denials and how can healthcare companies and patients combat this?

On today’s episode of the RCMchat podcast by AGS Health, host Michelle Dawn Mooney speaks with Matthew Bridge, SVP, RCM Service Line and Erica Franko, SVP of Customer Success, both of AGS Health, to discuss payor denial management in healthcare.

Mooney, Bridge, and Franko also discussed…

  • The recent trend in the uptick of insurance denials
  • Reasons why denials are up in healthcare
  • Suggestions for management within organizations struggling with the increase in denials


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Podcast – Trends in Payor Denials in the Healthcare Industry

Matthew Bridge

Matthew Bridge


As senior vice president of RCM services at AGS Health, Matt oversees strategic growth initiatives for the company’s Patient Access and Patient Financial Services business units. He possesses more than 15 years of experience in professional and managed services with expertise throughout the revenue cycle continuum. Matt’s career has provided him with broad experiences covering diverse provider settings and a deep understanding of the challenges facing customers of all provider types. He is passionate about mentoring and coaching others as they pursue their career journeys in revenue cycle and healthcare business management. Matt possesses a bachelor’s degree in business administration and management from Curry College in Milton, MA.

Erica Franko

Erica Franko