Denial Prevention & Recovery

Predict denials before they happen. When they do occur, let the original clinical encounter defend itself with AI-powered appeal generation.

The Problem

$262 Billion Lost Annually

Hospitals and healthcare providers lose $262 billion each year to denied claims. The denial management market is growing rapidly as organizations seek solutions to recover this revenue.

Average denial rate: 10-15% of all claims
65% of denials are never reworked
$25-$118 cost to rework each denial
Manual appeal processes take weeks

$262B

Lost to Denials Annually

Market growing to $8.93B by 2030

Current State

Denials pile up in work queues. Staff manually research each one, write appeal letters from scratch, and hope for the best. Most denials go unworked due to resource constraints.

Manual denial research & appeals
45% of denials never appealed
No root cause visibility

→

With Denial Intelligence

AI predicts which claims will be denied before submission. When denials occur, the system automatically generates appeals using the original clinical documentation.

72% appeal success rate
$2.3M average annual recovery
Root cause analytics dashboard

The Closed-Loop System

Where the clinical encounter itself defends the claim.

Predict

Machine learning models analyze claims before submission to flag high-denial-risk items. Fix issues before they become denials.

Defend

When denials occur, AI automatically drafts appeal letters using the original clinical documentation from AI-Scribe. Human experts review before submission.

Learn

Root cause analytics identify patterns across payers, procedures, and departments. Continuous improvement prevents future denials.

Capabilities

Denial Intelligence Features

Predictive Analytics: ML models trained on millions of claims identify denial risk
Auto-Appeal Generation: AI drafts appeals using original clinical documentation
Root Cause Dashboard: Visualize denial trends by payer, code, and department
Payer Intelligence: Track payer-specific denial patterns and requirements
Work Queue Prioritization: Focus staff on highest-value recovery opportunities
Human Expert Review: Certified coders validate AI outputs before submission

Denial Intelligence

Predict • Defend • Learn

72%

Appeal Success Rate

$2.3M

Avg Annual Recovery

40%

Denial Rate Reduction

24hr

Appeal Turnaround

Stop Leaving Money on the Table

See how Denial Intelligence can recover revenue and prevent future denials.

Schedule Demo Calculate Recovery Potential