Rejections vs. Denials: Know the Difference, Fix the Problem

This episode dives deep into the confusion many practices face when it comes to rejections vs. denials. Jennifer and Maya welcome back Cameron Lewellen to talk about how AI and automation can transform how practices handle claim issues, boost efficiency, and get paid faster.

From hilarious personal stories to hard-hitting truths about insurance delays, this episode is packed with real talk and practical insights.

• The difference between a rejection and a denial

  Rejections never make it through the system. Denials are processed and then kicked back due to payer rules or errors.

• Why automation matters

  AI (like Athelas) can prevent delays by correcting errors before submission, automatically resubmitting denials, and eliminating lag time.

• The power of site-specific vs. global rules

  Cameron explains how custom rulesets based on payer and specialty drastically reduce denials.

• Real-world examples

  Including one from an autism center battling denials from unlisted codes—and how automation fixed it.

• Domain-trained AI in action

  Think: bots that sit on hold with payers so your staff doesn’t have to. Yes, really.

• Underpayments and the dollars you're leaving on the table

  AI can track every claim and compare it to your fee schedule to recover revenue you didn’t even know was missing.

• The burnout problem

  We talk about billers working weekends, late nights, and how automation can protect your team’s well-being.

“AI works on Saturdays.” – Cameron Lewellen

“You earned every dollar. AI helps you collect it.” – Jennifer McNamara

“Appeal letters should be short and to the point. If it’s two pages long, no one’s reading it.” – Maya Turner

• Clearing up common misconceptions about rejections vs. denials

• How AI augments—not replaces—your revenue cycle team

• Using data to identify patterns and prevent denials

• UI/UX in RCM software: why it matters

• Operational tips for using automation to protect your AR

• Benchmarking payer behavior and setting smarter expectations

• Athelas – Learn more about their AI-driven RCM platform

• Bone & Joint Summit – Join us July 17–18 to meet the Athelas team in person

• Contact Cameron Lewellen for your free financial health analysis