According to Microsoft’s official website, rural hospitals provide vital care to isolated communities but face mounting challenges—from workforce shortages to financial strain—that threaten their ability to serve patients. A recent study estimates that more than 700 rural hospitals in the United States are at risk of closure due to financial hardship.
In response, Microsoft’s Rural Health Resilience Program is helping these organizations build resilience and improve financial sustainability. The program sits within Microsoft Elevate, a broader commitment to expand access to AI tools and skills across sectors, including healthcare.
Microsoft now offers a free, AI-powered claims denial navigator in the GitHub Models catalog, developed with Microsoft Partners and rural health leaders through the Rural Health AI Innovation Lab (RHAIL). The tool helps hospitals process denied claims more efficiently so they can receive appropriate reimbursement, and it’s available to any provider—from small rural clinics to large urban health systems.
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Turning denied claims into quicker reimbursements
Denied claims are a major financial burden, especially for small hospitals. While many denials are eventually overturned, the average small hospital spends about USD 330,000 annually to manage them, tying up staff time, delaying cash flow, and driving up administrative costs. Statistical analyses indicate denial rates average 18% in rural hospitals versus 10% in urban facilities.
The claims denial navigator aims to change that. It streamlines resolution of denied Medicare, Medicaid, and commercial claims, recommending the most effective next steps for billing teams and continuously learning from users’ actions and feedback. The free tool is designed to be secure (no data leaves the organization) and straightforward to deploy, enabling benefits such as:
- Faster revenue flow by reducing research and resolution time
- Quicker onboarding and upskilling of billing staff
- Better financial outcomes through more claims resolved at lower cost
“Southern Coos Hospital & Health Center recently transitioned [to a new] electronic health record system. As part of this process, we prioritized an accelerated rundown of our legacy system. Our revenue cycle team leveraged the denial management app to support this effort, reducing the legacy rundown timeline by several months. Participation in the RHAIL program also demonstrated the value of developing low-cost, targeted applications in key operational areas like revenue cycle.”
—Scott McEachern, Chief Information Officer, Southern Coos (Bandon, OR)
Microsoft is partnering with the Texas Office of Rural Clinics and Hospitals (TORCH) to support member deployments and track outcomes, while the Washington State Hospital Association is helping members access the tool and share learnings. Slalom, Microsoft’s design and development partner, will assist broader adoption through its Public and Social Impact team.
“After decades of working to improve healthcare access and equity, I’ve seen how systemic financial pressures threaten the survival of rural hospitals. The claims denial navigator represents a critical step forward—an AI-powered tool that empowers rural providers to recover revenue more efficiently, strengthen their financial footing, and continue delivering essential care to their communities,”
—Dr. Jim Weinstein, Senior Vice President, Microsoft Health—Innovation; former Director of the Dartmouth Institute and CEO of Dartmouth Health
