H.H.C. Group Releases White Paper on Independent Reviews in an AI-Driven Claims Environment

ROCKVILLE, Md., Feb. 02, 2026 (GLOBE NEWSWIRE) -- H.H.C. Group (H.H.C.), the leader in reducing healthcare costs by providing high-quality cost containment through claim negotiation, repricing and independent review solutions, announces the release of its newest white paper, Independent Reviews & Utilization Reviews: Payors’ Ally in an AI-Driven Claims World. The paper examines how objective, board-certified medical reviews help payors reduce compliance risk, prevent costly appeals and protect plan assets amid the surge in AI-generated denials.

“As AI tools increasingly drive coverage decisions, the risk of inappropriate or unsupported denials has never been greater,” says Bruce D. Roffé, Ph.D., president and CEO, H.H.C. Group. “Our white paper underscores how independent reviews can restore essential human oversight—ensuring every decision is grounded in medical necessity, legal defensibility and patient care standards.”

Sixty-one percent of physicians say AI is driving higher prior-authorization denial rates, with some systems producing care denial rates up to 16 times higher than typical, fueling costly appeals, audits and litigation.

Key Insights from the White Paper:
• AI-powered denials: Automated coverage decisions are triggering record volumes of appeals and audits.
• Regulatory pressure rising: Even one unsupported denial can lead to penalties or legal exposure.
• Independent Reviews mitigate risk: Evidence-based determinations by board-certified specialists provide unbiased, defensible justification.
• Fast turnaround, broad expertise: Most reviews completed within 5–7 days, urgent cases in 24 hours, across 84+ specialties.
• Audit-ready documentation: URAC-accredited processes ensure every determination withstands scrutiny.

“Independent reviews are about both fairness and protection,” Roffé adds. “They reduce disputes, defend determinations and show regulators you got it right the first time. This is where human expertise makes the difference—and it’s what our clients count on every day.”

With attorney-led reviewers, certified coders, licensed pharmacists and 30 years of trusted provider relationships, H.H.C. Group ensures every dollar paid is clinically necessary, contractually defensible and financially fair.

Download the white paper here.

About H.H.C. Group
Dedicated to significantly reducing medical claims costs through claim negotiation, repricing and medical bill review, H.H.C. Group is a national healthcare cost-containment leader serving self-funded healthcare payors, TPAS, stop-loss carriers/captives, unions and insurers. Serving the Group Health, Workers Compensation and Auto-Health markets, H.H.C. Group delivers timely, customizable solutions and proven savings. Committed to integrity and compliance, URAC-accredited H.H.C. Group stands out as a trusted partner for reducing healthcare costs and ensuring quality outcomes.

Media:
Brittany Tedesco
CPR Marketing
btedesco@cpronline.com
201-641-1911x14

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