Michael Nikitin
Kirkland, Washington, United States
9K followers
500+ connections
9K followers
500+ connections
About
I build and run healthcare systems in production.
I’m the co-creator and CTO of AIDA…
Articles by Michael
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9K followers
Michael Nikitin replied to a comment
1d
Facundo Alvez Exactly. That’s the hidden operational layer most organizations underestimate.
By the time a denial appears, the failure often happened days or weeks earlier - during eligibility verification, authorization sequencing, documentation capture, charge reconciliation, or care coordination.
And you’re absolutely right that these workflows are still treated as isolated functions instead of a connected operational system.
One of the biggest issues we see is that hospitals can track what was billed, but they often lack visibility into what should have been billed, what stalled mid-workflow, or what never reached the claim stage at all.
That’s why unbilled AR and operational leakage are so difficult to detect with traditional RCM tooling.
Really thoughtful breakdown, Facundo.
Michael Nikitin replied to a comment
1d
Yemi Mateola, MBA, CPHIMS Absolutely. And in many cases, they don’t even realize the revenue was lost because the workflow failure happened upstream long before billing.
What makes unbilled AR especially dangerous is that it often sits outside traditional denial management visibility. If the encounter never fully progresses through the operational workflow, there may be no denial to appeal at all.
That’s why operational orchestration between clinical workflows, authorization, documentation, and revenue cycle is becoming so critical.
Michael Nikitin replied to a comment
1d
Anna Komarova, MD Exactly. This is one of the biggest hidden failures in healthcare operations - the disconnect between clinical intent and financial execution.
Most clinicians are focused on delivering care, not on how documentation quality, authorization timing, coding specificity, or workflow sequencing impact downstream reimbursement. But revenue leakage often starts upstream, long before a claim is generated.
That’s why unbilled AR is so dangerous. It’s not always visible in traditional RCM dashboards because the encounter may never fully enter the billing workflow in the first place.
Closing that gap requires operational visibility between clinical workflows, documentation, utilization management, and revenue cycle - not just retrospective billing cleanup.
Really important point, Anna.
Experience
Education
Licenses & Certifications
Patents
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System and method for facilitating patient discharge with the aid of a digital computer
Issued US11049607B1 62500392
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English
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Russian
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