Identifying the root causes of denials
Editor’s note: Monica E. Oas, CPC, CPMA, will present “Grab a Shovel: Digging for True Root Causes in Denial Data” on day one of the 2026 Revenue Integrity Symposium, which will take place September 24–25 in Savannah, Georgia. Oas is an enterprise denials program manager at UC Davis Health in Sacramento, California. Download the 2026 RIS brochure to learn more about the event! Use NAHRI’s justification letter template as a guide to gain your organization’s support for attending.
Q: In what ways does your session challenge attendees to think outside the box?
Oas: This session challenges attendees to move beyond treating “root cause” as a buzzword and start thinking about what it actually requires in practice. In denial work, root causes are rarely obvious; they’re often buried beneath layers of workflow, system behavior, and operational nuance. Getting to them means doing the digging, looking beyond the surface signal, and untangling what’s really driving the outcome.
Q: What’s the biggest challenge in revenue integrity and/or revenue cycle right now? How does your session help tackle this?
Oas: One of the biggest challenges in revenue cycle today is navigating a payer/provider dynamic that doesn’t always operate on a level playing field. Denials can occur for valid reasons, but also for reasons that are unclear, inconsistent, or difficult to influence.
The real challenge is distinguishing what is within our control from what requires a different strategy, whether that’s escalation, contract alignment, or payer engagement.
This session helps tackle that by focusing on how to accurately identify the true drivers behind denials. When you understand the core issue, you can apply the right solution, whether that’s an internal process change or a more strategic payer-focused approach.
Q: What’s one of the key pieces of information you would like people to take away from your session?
Oas: One of the key takeaways from this session is the importance of challenging assumptions, especially when working from incomplete information. In denial data, the first explanation is not always the right one. I want attendees to strengthen both their skill and their instinct to do the detective work: validate, test, and let their understanding of a problem evolve as clearer information emerges.
Q: What are you most excited about for this year’s conference?
Oas: I’m especially excited to be a first-time presenter and to share real, practical experiences with others who are working through many of the same challenges. I’m also looking forward to the conversations that happen outside the sessions, hearing how others are approaching similar problems and exchanging ideas that we can all take back and apply in our own organizations. And on a personal note, I’m excited to experience Savannah for the first time. I’ve heard it’s a beautiful city with a lot of character.
Q: What's a great piece of advice you've received regarding revenue integrity and/or revenue cycle? Or, what advice do you like to give people about revenue integrity and/or revenue cycle?
Oas: A great piece of advice I’ve received is to stay curious longer than you’re comfortable. There’s often pressure to quickly define a problem and move to solutioning, but in revenue cycle, the first answer is rarely the full story. Taking the time to ask a few more questions, test assumptions, and explore patterns more deeply often leads to much more accurate, and ultimately more impactful, solutions.