Claims Denial Pattern Analysis at MidSouth Health Partners

MidSouth Health Partners is a mid-sized multi-specialty physician group with 140 providers across 12 clinic locations. Their revenue cycle team processes claims to commercial and government payers, and has been experiencing a rising denial rate that is straining the appeals workflow and delaying cash collections.

Over the past two quarters, the overall denial rate has held steady at around 20%, but the revenue cycle team has noticed that denials are disproportionately hitting high-value claims — particularly in surgical and imaging services, where denial rates are nearly double the average.