The Claim That Never Gets Denied: Patti Peets’ Blueprint for an AI-Driven Revenue Cycle

On this episode of the MGMA Insights Podcast, host and senior editor Daniel Williams sits down with Patti Peets, chief revenue and client experience officer at UnisLink, to explore how artificial intelligence is reshaping revenue cycle management. Peets explains why dashboards alone do not improve financial performance, how AI can help prevent denials before claims are submitted and why practices should evaluate technology based on measurable outcomes rather than price or features alone.

Episode Takeaways

A high-performing revenue cycle in 2026 should be predictable, measurable and increasingly managed by exception rather than through manual review of every transaction.Peets identifies several benchmarks practices can monitor, including a net collection rate of approximately 95% to 96%, a clean-claim rate of at least 98%, an overall denial rate below 7% and 35 or fewer days in accounts receivable. Charge lag, claim submission time, aging and first-pass resolution can also reveal problems before cash flow is affected.Dashboards show what happened, but they do not automatically lead to better results. Revenue cycle leaders must identify why a KPI changed, determine who owns the corrective action, establish a deadline and measure whether the intervention worked.AI is creating value through capacity and exception management. Technology can process predictable, repetitive work while directing staff toward claims and accounts where human judgment can change the financial outcome.Denial prevention is one of AI’s most promising revenue cycle applications. Predictive tools can analyze payer behavior and historical claims data to flag claims that are likely to be denied, including problems that may not be covered by an existing rule or front-end edit.Practices should examine how well an AI product integrates with their practice management system. A tool operating outside the core platform can add cost and workflow complexity if data and tasks do not move smoothly between systems.The vendor with the lowest fee may not deliver the lowest economic cost. A higher-priced RCM partner could generate greater value by improving the net collection rate, reducing aging accounts receivable and preventing more denials.Technology evaluations should consider the complete financial picture: how much earned revenue becomes cash, how quickly it is collected and the total cost required to collect it. Clinical workflow also matters, especially whether physicians can document care effic