Why Timely Filing Failures Are Self-Inflicted Denials

The Road to Zero-Touch RCM: Agentic AI, Denials Prevention, and Operator Ownership in Revenue Cycle

David Kelly · Chief of Ambulatory Operations & Vice President of Revenue Cycle, Mary Rutan Health

David Kelly returns to the RC Executive Lounge for his second appearance to discuss claims denial management with a focus on prevention, operator ownership, and what it takes to drive step-function improvement at a community hospital. Drawing on more than 19 years of healthcare experience and his role as Chief of Ambulatory Operations and Vice President of Revenue Cycle at Mary Rutan Health, David frames denials management as a multi-year discipline shaped by a constantly shifting payer landscape, and walks through his framework for defining denial never events, the rise of records requests as a top denial driver, and why benchmarking against state-level payer scorecards is more meaningful than national averages. The conversation covers a recent clearing house migration at Mary Rutan, including how his team executed a 100-day go-live with minimal disruption to gross denial rates, the lessons learned around codifying vendor commitments in writing and building training specificity into the project plan, and how he measures success for a migration of that scale. David shares a genuinely split perspective on agentic AI and the vision of zero-touch RCM: deep optimism about what autonomous agents could accomplish if they could touch every denial, reduce the number of passes required to resolve a claim, and ingest thousands of annual payer policy changes faster than any human team, alongside realistic concern about the uncertain road ahead and the public backlash against patient-facing AI. He closes with his view of yield as the A1C equivalent for revenue cycle health, the three barriers he sees most often blocking step-function improvement, and his core leadership principle: bring denials to the clinical operators, because that is where most denials originate and where the most effective prevention partnerships are built.