What Venmo and J.P. Morgan Taught Us About Fixing Denials in Healthcare
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When Venmo launched in 2009, it didn’t just create a new way to split a dinner bill—it introduced a user experience so intuitive, so fast, and so reliable that it permanently changed how people think about money movement. No more waiting for checks to clear or logging into clunky bank portals.
In the years since, Venmo, now owned by PayPal, has built a brand around transparency, automation, and real-time visibility into transactions. In parallel, J.P. Morgan Chase has invested heavily in digitization, streamlining everything from institutional payments to consumer healthcare transactions.
Meanwhile, in healthcare, revenue cycle leaders still wrestle with claim denials triggered by eligibility mismatches, documentation delays, or prior authorization hiccups—often relying on siloed systems and retroactive workflows. The contrast between financial innovation and healthcare stagnation couldn’t be starker. But what if healthcare borrowed a few pages from fintech's playbook?
This blog explores how lessons from fintech leaders like Venmo and J.P. Morgan can inspire a smarter, more proactive approach to healthcare denial management.
Fintech First: What Venmo and J.P. Morgan Got Right
Venmo’s early innovation wasn’t just about tech; it was about trust. The platform made peer-to-peer payments feel instant and social. Users could see who paid whom, include notes or emojis, and receive confirmations immediately.
This experience was driven by:
- Automation: Transactions were triggered and recorded without manual intervention.
- Visibility: Both sender and receiver had real-time status updates.
- User-centric design: It made finance feel simple—even fun.
J.P. Morgan took a more enterprise-grade approach, focusing on streamlining institutional transactions with automation, AI, and digital-first strategies. They invested in real-time payments, fraud detection, and online portals for automated billing—all aimed at reducing friction.
In both cases, fintech players succeeded by building systems that anticipate and resolve issues before they impact the end user. That’s the mindset healthcare needs when it comes to denials.
Denials Are Healthcare's Transaction Failures
A denial is the healthcare equivalent of a failed payment. It signals a disconnect between the payer and the provider, whether due to missing information, eligibility confusion, or coding errors. But while fintech systems are designed to identify and prevent failures in real time, healthcare revenue cycle systems often discover denials weeks or months after a claim is submitted.
This postponement impacts cash flow and adds to operational sluggishness. Staff must rework claims, chase down documentation, or appeal denials, all of which adds to cost-to-collect. In many cases, these denials were entirely preventable.
3 Fintech-Inspired Strategies for Fixing Denials
1. Predictive Automation: Prevent Denials Before They Happen
Just as Venmo validates a transaction before you send it, healthcare platforms should validate claims before they go out the door. This includes checking:
- Patient eligibility in real time
- Authorization status
- Clean claim formatting and coding
Fintech leverages machine learning to detect anomalies before they create risk. Healthcare can do the same by training AI on denial patterns to flag likely issues and guide front-end staff toward corrections.
2. Real-Time Visibility: Denial Alerts as Transaction Notifications
Think of how Venmo or J.P. Morgan sends a notification the second a transaction processes. Healthcare providers should have dashboards that deliver similar alerts:
- Claims missing documentation
- Authorizations that may expire
- Payers with high denial rates on specific procedures
This kind of real-time alerting transforms denial management from a reactive burden into a proactive workflow.
3. Integrated Experience: Break the Silos
Venmo succeeds partly because it integrates messaging, payments, and notifications into one platform. J.P. Morgan connects banking, payments, and reporting. In healthcare, RCM teams often toggle between EHRs, billing software, and payer portals.
Combining these workflows in one interface or using smart automation can lower errors and increase speed. The less time staff spend chasing data, the more time they can spend preventing denials.
Case Example: Fintech-Like Impact in Healthcare
A rural hospital working with Jorie AI saw its eligibility denial rate drop to just 0.3%. This wasn’t by accident. By automating eligibility verification and flagging inconsistencies before submission, the hospital achieved something fintech platforms like Venmo and J.P. Morgan have mastered: proactive correction at scale.
Just like Venmo checks account details and J.P. Morgan runs fraud checks, this hospital used automation. They ensured clean data before claims left the system. This shows that the same ideas from finance can greatly improve healthcare operations.
Another health system integrated its RCM workflows and saw a 15% increase in collected payments. When data flows seamlessly and the system knows what to look for, the impact is tangible.
Why Now? The Denial Landscape Is Getting Worse
According to recent Becker's reports, Medicare Advantage denials surged over 50% year-over-year. Many of these denials are driven by automated insurer reviews, which ironically make the case for providers to automate too. If payers are using AI to deny faster, providers need AI to defend faster—and ideally, prevent denials in the first place.
Patients, too, are growing less tolerant of billing confusion. In an age where consumers can move money instantly, they expect the same clarity from their medical bills. Fintech has raised the bar.
Conclusion: Denial Prevention Is the New Revenue Strategy
Venmo didn’t succeed because it solved payments after they failed. It thrived because it built a system where failures were rare to begin with. J.P. Morgan isn’t digitizing healthcare transactions to chase money—they’re doing it to make the transaction seamless from the start.
Healthcare organizations that want to improve their bottom line should stop treating denials as inevitable. Instead, they should look to fintech’s example and build revenue cycles where denials are the exception, not the norm. That means automation, integration, and real-time intelligence—and it means starting now.
Because in the new world of healthcare finance, fixing denials isn’t just a back-office function. It’s a competitive advantage.
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