Elizabeth Venafro

Revenue loss hides in paid claims, not denied ones

Venafro argues that healthcare revenue leakage is systematically invisible because underpaid claims post as completed transactions, while denied claims trigger visible workflows that demand resolution. The real financial risk lies not in claims that get rejected, but in claims that get paid below contract terms yet close without escalation.

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claim scenarios that appear correct but aren't

“A denied claim gets a queue. A paid claim that came in lower than expected gets none of that.”

Denials get a queue, underpayments just look like paid claims

Three payment scenarios and their visibility in revenue cycle workflows

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orthopedic claims coded correctly yet underpaid per contract

A zero payment on a claim line can look like missing revenue. It isn't.

A zero-paid claim line is not automatically an underpayment

Both claims were handled correctly. That still doesn't mean the practice got paid what its contract says.

A clean, paid, closed claim can still be short of the contract