Why the Best RCM Experts Are Already on Your Team with Ken Hogue | Podcast Shorts from ArceeHQ

In this clip

Ken Hogue offers a single piece of advice to revenue cycle leaders tackling denial management challenges: look inward before reaching outward. The expertise needed to drive meaningful change is almost always already present in cross-functional teams, and the leadership task is to convene those people, ask the right questions, and give them a structured working group where their insights can be shaped into actionable decisions. From there, partnering with vendors and technology can accelerate execution, but the foundation should be built from the knowledge already inside the organization.

Key Takeaway

Before engaging vendors or deploying new technology, revenue cycle leaders who convene the internal expertise already on their teams will find faster, more durable paths to improvement than those who start by looking outside.

“most of the time your experts at knowing how to make those changes are already within your organization.”
Ken Hogue, Chief Revenue Officer, United Health Services

LeadershipClaims Denial Management

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Ken Hogue

Season 2 · Episode 11 · 45 min

Building a High-Reliability Revenue Cycle: Denial Prevention, Agentic AI, and Leadership at United Health Services

Ken Hogue · Chief Revenue Officer, United Health Services

Ken Hogue brings a high-reliability organization framework to claims denial management, drawing on his leadership at United Health Services, the largest comprehensive healthcare system in the Greater Binghamton, New York region, where he has led revenue cycle transformation since 2020, including a landmark Epic implementation. He explains how UHS built its denial prevention capability into the foundation of its Epic deployment rather than layering it on afterward, how the HRO model has created a prevention-first culture with a dedicated SWAT team of denial resolution specialists, and how root-cause analysis drives decisions about when to apply technology automation versus front-end process discipline. The conversation covers a recent alternate payer and third-party liability verification initiative, the touches-per-clean-claim metric as a primary measure of initiative success, and Ken's framework for navigating the tension between operational quick wins and longer-horizon technology investments through sprint-based governance and compromise models. On agentic AI, Ken is direct that organizations no longer have a choice about whether to embrace it because payers are already using it, and describes the risks of automation fragmentation when policies change, the evolution of revenue cycle management toward managing people and technology workflows simultaneously, and the clean claim pass rate as his primary daily indicator of organizational health.

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The themes our guests cover are the same ones our executive guides and ROI calculators are built around. If this clip resonated, here’s where to take it next.

Claims Denial Management, powered by agentic AI

How ArceeHQ catches denials before they happen, resolves them automatically, and gives your reviewers only the cases that need a human.

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Executive Guide

Reducing claim denials with agentic AI

A practical framework for revenue cycle leaders. Covers the operating model shift, what to measure, and where automation actually pays.

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Model the revenue impact of a first-pass rate improvement at your health system. Plug in your denial volume and payer mix.

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