In this third episode of Igniting the Aurora, we turn our attention to one of the most overlooked threats to revenue integrity as we move toward 2026: downcoding.

Rather than focusing on denials, this episode examines how reimbursement is increasingly eroded quietly—through payer-driven reclassification, retrospective clinical validation, and internal undercoding driven by documentation ambiguity. We explore why downcoding often goes undetected, why it’s rarely appealed, and how it becomes normalized within organizations over time.

Through examples, payer behavior analysis, and practical detection strategies, this episode unpacks how downcoding impacts case mix index, data integrity, professional trust, and long-term financial sustainability. Listeners will gain insight into how documentation clarity functions as a financial control point—and what high-performing organizations are doing now to identify severity drift, recognize hidden payer signals, and protect reimbursement before loss occurs.

This episode is designed for clinicians, coders, CDI specialists, auditors, and revenue integrity leaders who want to move beyond reactive denial management and develop a proactive, strategy-driven approach to documentation, coding, and payer behavior heading into 2026.