Better notes can cut the denials that turn on documentation. Only those. Initial claim denials hit 11.81% in 2024, and two of the fastest-growing categories, medical necessity and requests for more information, trace straight back to whether the record supports the claim. A complete, legible note gives your biller what a payer asks for. We’ll be precise here about what a scribe touches and what it doesn’t, because overclaiming on revenue is where this topic usually goes wrong.
One thing to settle up front: an AI scribe is not a billing tool. It doesn’t submit claims, it doesn’t adjudicate them, and it never sees your clearinghouse. What it does is improve the note that every one of those downstream steps depends on. Real lever, narrow one.
Key takeaways
- Initial denials hit 11.81% of claims in 2024, up 2.4%, per Kodiak Solutions (2,100+ hospitals, 300,000 physicians). About 1 in 8 claims bounces first time.
- Two rising denial categories, medical necessity and requests for more information, are documentation-dependent.
- A better note helps the documentation-driven denials only; it does nothing for eligibility, authorization, or timely-filing denials.
- An AI scribe improves the note, not the billing workflow. It does not submit, code, or integrate with claims systems.
initial claim denial rate in 2024, up 2.4% (Kodiak Solutions)
claims denied on first submission, 2024
rising denial categories tied to documentation: medical necessity and requests for more information
How big is the claim-denial problem in 2024?
Worse, and the numbers come first-party from a large dataset.
Kodiak Solutions, analyzing claims from more than 2,100 hospitals and 300,000 physicians, reported that the initial denial rate rose to 11.81% of claims in 2024, an increase of 2.4% over the prior year. Roughly one in eight claims now gets denied on first submission. That’s not the final write-off rate. Plenty of denials get overturned. But each one is rework, delay, and cost before the money ever lands.
What’s driving the increase matters for our question. Kodiak found that even as providers cut authorization-related denials by 7.7%, denials tied to medical necessity and requests for more information rose by 5% and 5.4% respectively, more than making up the difference. Those two categories are the documentation-sensitive ones. A payer questioning medical necessity or asking for more information is, in effect, saying the record didn’t make the case on its own.
Which denials does documentation actually affect?
Not all of them. This is the distinction that keeps the claim honest.
| Denial type | Documentation-driven? | Can a better note help? |
|---|---|---|
| Medical necessity | Yes | Yes, a note that captures clinical justification |
| Request for more information | Yes | Yes, a complete note answers the question upfront |
| Insufficient documentation | Yes | Yes, directly |
| Eligibility / coverage | No | No, that’s a front-desk/verification issue |
| Prior authorization | No | No, that’s a process step before the visit |
| Timely filing | No | No, that’s a submission-deadline failure |
The pattern is simple: documentation helps where the note is the evidence, and does nothing where the failure happened somewhere else in the process. If your denials are mostly eligibility and authorization, a better note won’t move your numbers, fix the front-desk and pre-auth workflow instead. If they’re medical necessity and information requests, the note is squarely in play.
How does a better note reduce documentation-driven denials?
By handing the biller and the payer the clinical story, complete and legible, the first time.
A denial for medical necessity or a request for more information is usually a gap. The claim asserted something the record didn’t fully support, or the documentation was too thin to stand on its own. The fix sits upstream: a note that captures the clinical reasoning, the relevant findings, and the plan clearly enough that the justification is visible without an appeal. When the note is complete, the coder has what they need to bill it cleanly. And if a payer does push back, the record is there to defend it.
This is where an ambient scribe earns its keep, and the mechanism is worth stating exactly. AI Medical Scribe by Patient Square is an ambient AI medical scribe that listens during the visit and hands back a structured SOAP note, ICD-10 suggestions, and a prescription draft, ready to review and sign about two minutes after the visit. A note written at consultation pace, while the details are still fresh, tends to be more complete than one reconstructed from memory at 9pm. Completeness is exactly what the documentation-driven denial turns on. And the ICD-10 suggestions are just that, suggestions for your coder to confirm, not a coding engine. The note quality that makes this work is something you can grade yourself with our SOAP-note rubric, and the buyer’s view is in how to evaluate an AI medical scribe.
What a scribe does not do for your denials
This is the part vendors blur, so here’s the boundary drawn plainly.
It doesn’t submit or adjudicate claims. AI Medical Scribe by Patient Square has no connection to your billing system, clearinghouse, or payer. It drafts notes, and your existing revenue-cycle process does the rest.
Coding isn’t its job either. The ICD-10 suggestions speed your coder up; they don’t replace one. A scribe that claims to “code your bills” is overselling, and we make that distinction at length in how accurate are AI medical scribes.
Then there are the process denials, which it can’t touch. Eligibility, authorization, and timely-filing denials are workflow failures upstream or downstream of the note. A better note won’t move them, and we won’t pretend it can.
So the honest framing is narrow. An AI scribe improves documentation, documentation is a growing driver of denials, and a more complete note is easier to bill and to defend. That’s the lever. It’s not a revenue-cycle platform, so don’t buy it as one.
See the note quality before you bank on the billing benefit
The denials benefit is downstream of one thing: whether the note is actually more complete on your visits. That’s testable.
Book a demo to see a structured note appear about two minutes after a sample visit, then run the 7-day free trial and check whether your notes come out more complete than your current end-of-day reconstructions. If they do, the documentation-driven denials are the ones that benefit. For the time-and-money side, see the real ROI of an AI scribe; for the after-hours angle that ties into note completeness, beating pajama time; and for the full documentation-burden picture, the pillar on cutting charting time. The receipts on security and data handling are on our security page.