Xsolis Denial Resolution for Hospitals and Health Systems

Denial Management and Resolution Services

Xsolis' professional denial management and recovery team undertakes denial and appeal management on your behalf, identifying cases with justified clinical merit and building the case for appropriate appeal and revenue recovery.

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Group of doctors talking to ACO representative about Denial Management

Revenue recovery based on The clinical merit of Each Case

To maximize your appropriately recovered revenue, Xsolis deploys dedicated industry experts to navigate inefficient payer appeal channels and work with the payer on the demonstrated clinical merit of each case.

Our team and approach includes a combination of clinical, legal, and revenue cycle experience, including auditors, denial management specialists, recovery experts, CDI (Clinical Documentation Improvement) specialists, and case managers

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Our 360° Approach to denial management Services

Target The Right Cases

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Xsolis applies powerful Machine Learning algorithms to identify and prioritize denial resolution cases with strong clinical merit and most appropriate for appeal.

Defensible Decisions

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Our denial management services paired with our proprietary data management platform, defend admissions decisions to payers both concurrently, while the patient is still in the hospital, and retrospectively in the event of a denial. Complex denials are reviewed and resolved 3–5 times more efficiently than with typical methods.

Evidence-Based Analysis

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No two cases or corresponding appeal letters are the same. We identifiy denial resolution cases with demonstrated clinical merit though an analytics-based approach. We offer actionable denial management analytics for key case metrics, including admitting or discharge diagnosis, procedure, length-of-stay, or downgrade and denial outcomes.

Target The Right Cases Defensible Decisions Evidence-Based Analysis

magnifying glass

Xsolis applies powerful Machine Learning algorithms to identify and prioritize denial resolution cases with strong clinical merit and most appropriate for appeal.

medical alert shield illustration

Our denial management services paired with our proprietary data management platform, defend admissions decisions to payers both concurrently, while the patient is still in the hospital, and retrospectively in the event of a denial. Complex denials are reviewed and resolved 3–5 times more efficiently than with typical methods.

line chart illustration

No two cases or corresponding appeal letters are the same. We identifiy denial resolution cases with demonstrated clinical merit though an analytics-based approach. We offer actionable denial management analytics for key case metrics, including admitting or discharge diagnosis, procedure, length-of-stay, or downgrade and denial outcomes.

Resources

Xsolis Press Releases

UMC Health System Extends Its Success with Xsolis’ Dragonfly Solution, Physician Advisory and Denials Management Services

AI-backed platform provided operational efficiency and improved payer relations, leading to expansion NASHVILLE, Tenn., Sept. 19, 2023 – Xsolis, the artificial intelligence (AI) technology company creating a more efficient healthcare […] Case Study

UMC Healthsystem

AI-Powered Workflows Deliver 20% Shorter Length of Stay and Operational Efficiencies

Partnering with Xsolis to Innovate UM & Improve Outcomes: In the search for a more sustainable approach to case management and UM, UMC Health partnered with Xsolis to help them […] Case Study

Hillcrest HealthCare System

“Getting to Right”

Hillcrest HealthCare System Rikki Moye doesn’t take things as they are. When entering her leadership role at Hillcrest HealthCare, Rikki knew she would face the same problems that plague care […]

Improve your A/R days

Our professional services are tailored to your individual needs and supportive of your processes.
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FAQs

Denial resolution is the process of appealing denied claims and securing payment. Doing it well and successfully improves cash flow, assists in revenue recovery, and supports consistency in clinical decision-making. The right approach protects both your healthcare organization's bottom line and your staff’s time.

Denial management services use clinical and financial data to identify appealable cases, generate strong justifications, and resolve denials faster. Through an analytics-based approach from AI-driven tools, organizations experience continuous performance improvements, gain insights and identify trends in denial patterns.

Denial management services combine clinical, legal, and financial expertise and tools to review and appeal denied claims from patient cases to recover revenues. They streamline appeals, support defensible decisions, and help reduce future denials. When powered by AI-driven solutions, these services improve speed, accuracy, and recovery rates with less effort from your team.

External denials management services reduce administrative workload by handling appeals from start to finish, with speed and efficiency. Backed by data and analytics, with clinical and legal experts specialize in overturning complex denials, managing each case and AI supporting review prioritization, your internal teams stay focused on patient care.