7 Best Practices for Revenue Cycle Management in 2025 

$16.3B

Projected lost revenue from RCM inefficiencies in 2025

15-20%

Average claims denial rates across health systems

$118

Average cost to rework a single denied claim

60%

Of denied claims never resubmitted, representingpermanent revenue loss

1.  Optimize patient access and front-end verification

Most denials do not originate in the billing department. They originate at registration. Inaccurate demographic information, missed eligibility checks and incomplete insurance verification are the leading drivers of avoidable claim denials. The reason is straightforward: errors introduced at the front end travel through the entire revenue cycle, compounding at each stage.  High-performing organizations invest heavily in real-time eligibility verification at or before the point of service. They also standardize intake workflows to capture insurance and demographic data consistently. When patients understand their financial responsibilities before receiving care, collection rates improve and billing disputes decline.

Advantum insight: Advantum Health’s front-office support services integrate scheduling, patient verification and customer service into a single, coordinated workflow, reducing front-end errors before they become back-end billing problems.

2.  Strengthen clinical documentation and coding accuracy

Poor clinical documentation is responsible for more than half of all claim denials, according to data from the Healthcare Financial Management Association. When clinical notes do not clearly support the billed diagnosis or procedure, payers have both the justification and the financial incentive to deny. Coding inaccuracies compound the problem, creating compliance exposure alongside revenue loss.  Leaders should invest in certified medical coders and establish continuous audit cycles. Regular documentation improvement programs, which bring together coders, physicians and clinical informatics teams, are among the highest-return interventions available to revenue cycle leaders. Accuracy at this stage dramatically reduces rework downstream.

Advantum insight: Advantum Health employs certified medical coders and conducts ongoing coding audit services to maximize charge capture while maintaining strict compliance standards.

3.  Shift from reactive to proactive denial management

The traditional approach to denial management is reactive: claims are denied, staff investigate the cause and appeals are filed. This cycle is expensive, time-consuming and, for the 60% of denied claims that are never resubmitted, ultimately futile.  Leading organizations have inverted this model. By analyzing denial patterns, identifying root causesand intervening upstream in the workflow, they prevent denials before they occur. Predictive analytics tools can flag claims likely to be denied before submission, enabling staff to address deficiencies while there is still time to act. Each denied claim costs an average of $118 to rework; prevention is always more efficient than remediation.

Advantum insight: Advantum Health’s denial management services combine proactive prevention strategies with prompt resolution of existing denials, including oversight of the full prior authorization process to reduce friction with payers.

4.  Accelerate accounts receivable follow-up and reduce days in AR

Days in accounts receivable is one of the most closely watched indicators of revenue cycle health, and for good reason. Extended AR cycles suppress cash flow, increase write-offs and signal process breakdowns across the organization. More than 40% of providers report that it takes two or more months to receive reimbursement for services rendered, with Medicaid payments often stretching well beyond six months, according to a 2025 Medical Economics survey.  Systematic AR follow-up protocols, supported by workflow automation, are essential to keeping AR days within target range. Segmenting AR by payer, age and balance allows teams to prioritize their effort where recovery probability is highest. Organizations that implement structured AR management consistently outperform those relying on ad hoc follow-up.

Advantum insight: Advantum One, Advantum Health’s intelligent RCM platform, automates remittance posting, tracks AR aging and surfaces priority follow-up queues, helping teams work smarter and collect faster.

5.  Leverage automation and AI to scale revenue cycle operations

Artificial intelligence and automation are no longer emerging tools in revenue cycle management. They are table stakes. In 2025, organizations that have not deployed intelligent automation across the revenue cycle are competing at a structural disadvantage, particularly as payers increasingly use AI to adjudicate and deny claims.  AI-powered tools are now capable of automating eligibility checks, generating coding suggestions, flagging denial risks before submission, accelerating remittance posting and managing prior authorizations. The return on investment is measurable and well-documented. The goal is not to replace skilled staff but to redirect them from repetitive administrative tasks to the work that requires human judgment, payer negotiation and patient engagement.

Advantum insight: Advantum One combines machine learning, business intelligence and workflow automation to power the revenue cycle from end to end, giving finance and operations leaders real-time visibility and measurable efficiency gains.

6.  Build a patient-centered financial experience

The patient financial experience has become a revenue cycle variable that healthcare leaders can no longer treat as secondary. Research consistently shows that patients who receive clear cost estimates before care, access convenient payment options and receive transparent billing statements are far more likely to pay, and to return. In fact, 92% of patients who report a positive administrative experience are more likely to recommend their provider.  High-deductible health plans have made patients a significant payer class. Engaging them early, communicating costs clearly and offering accessible payment plans are no longer nice-to-have features. They are operational necessities. Transparency at the point of scheduling reduces billing disputes and improves collections on the back end.

Advantum insight: Advantum Health integrates patient-facing support across scheduling, financial counseling and billing communications, helping providers meet patients where they are and collect more of what is owed.

7.  Consider strategic RCM outsourcing to extend capacity and expertise

For many healthcare organizations, the question is no longer whether to outsource elements of the revenue cycle, but which elements to outsource and to whom. Staffing shortages, the complexity of payer requirements and the capital investment required to implement best-in-class RCM technology have made outsourcing a compelling strategic option for organizations of every size.  Outsourced RCM partners bring specialized expertise, scalable capacity and proven technology that would be prohibitively expensive to replicate in-house. They can absorb volume spikes, manage specialized functions such as denial management and credentialing, and continuously apply best practices developed across a broad client base. The result is not just cost savings, it is a measurable improvement in revenue performance.

Advantum insight: Advantum Health serves as a full-service RCM partner for hospitals, health systems and physician practices, providing the technology, expertise and white-glove support to optimize every stage of the revenue cycle.