Key Facts (At-a-Glance):
- Launch: Healthrise has launched Navigator AI, an embedded artificial intelligence layer within its Denials Navigator platform. Navigator AI is a healthcare revenue cycle AI tool designed to improve denial prevention, accelerate denial resolution and strengthen financial performance.
- Purpose: Navigator AI is designed to reduce preventable revenue leakage in the healthcare revenue cycle. It identifies upstream issues such as documentation gaps, coding inconsistencies, eligibility errors and missed charge capture before they result in claim denials or rework. This supports both denial prevention and revenue cycle optimization.
- How It Works: Navigator AI is embedded within the Denials Navigator workflow and functions as a real-time AI assistant for denial management. It analyzes denial cases, identifies likely root causes, recommends next steps and surfaces related claim patterns to support faster and more consistent decision-making.
FARMINGTON HILLS, Mich., May 20, 2026 (GLOBE NEWSWIRE) — Healthrise today announced the launch of Navigator AI, a new embedded artificial intelligence layer within its Denials Navigator platform designed to accelerate denial resolution, improve decision accuracy and support faster financial impact across healthcare revenue cycle operations.
Hospitals continue to operate on margins as thin as 1% to 3%, yet a significant share of revenue loss occurs before claims are ever denied. Meanwhile, denial rates are rising as a result of Medicaid and legislative shifts leading to increased payer complexity, tightening authorization requirements and growing administrative burdens — driving more rework and higher costs to collect.
Healthrise analysis shows up to 30% of preventable revenue leakage is driven by pre-bill and early-cycle breakdowns, including documentation gaps, coding inconsistencies, eligibility errors and missed charge capture opportunities. Once claims are corrected or denied, rework costs can range from $25 and $118 per claim, compounding administrative burden and delaying reimbursement.
Navigator AI is designed to address these upstream challenges by embedding real-time intelligence directly into the denial workflow.
“Denials are not the problem, they’re the symptom,” said David Farbman, Chief Executive Officer of Healthrise, a healthcare consulting and technology firm. “The real failure point is upstream, where preventable errors enter the revenue cycle long before a denial occurs. Navigator AI helps organizations identify root causes earlier, shift from reactive resolution to proactive prevention and improve overall financial performance.”
Navigator AI functions as a real-time assistant within Denials Navigator, delivering case-level insights, root-cause identification and resolution recommendations directly in the workflow. It summarizes denial cases, identifies likely drivers, recommends next steps and surfaces related patterns to support faster, more consistent decision-making.
Unlike general-purpose artificial intelligence tools, Navigator AI is purpose-built for revenue cycle operations and trained on denial workflows, payer behavior patterns and real-world resolution strategies, enabling more relevant insights and faster time to decision.
Denials Navigator connects denial patterns to connect issues back to upstream workflow, documentation and payer rule breakdowns, helping organizations understand not only what is denied, but why it is occurring at the source.
Healthrise said the platform reflects a broader shift in healthcare finance toward prevention-led revenue cycle strategies, as organizations place greater emphasis on identifying and correcting errors earlier in the billing cycle to reduce downstream rework and denial volume.
“What we’re seeing is a fundamental reset in how revenue cycle performance is defined,” said Farbman. “Organizations making the most progress aren’t just resolving denials more efficiently, they’re preventing the errors that create them. Prevention is becoming the performance metric that matters most.”
To learn more about Healthrise’s proactive revenue cycle solutions, including Denials Navigator and Navigator AI, visit www.healthrise.com.
About Healthrise
Healthrise is a healthcare consulting and technology firm that provides revenue cycle management, electronic health record optimization and strategic advisory services to hospitals and health systems across the United States. Founded in 2012, the company partners with organizations to improve financial and operational performance through customized, data-driven solutions. Healthrise has supported more than 25 health systems and managed over $35 billion in net patient revenue, helping clients strengthen long-term sustainability and care delivery. For more information, please visit www.healthrise.com.
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