XSOLIS provides denial management for hospitals.
To maximize your appropriately recovered revenue, XSOLIS deploys dedicated denial management, recovery, and clinical documentation specialists to navigate the cumbersome payer appeal channels, working with the payer on the demonstrated clinical merit of each case.
Our team undertakes your denial and appeal management backlog on your behalf, identifying cases with justified clinical merit, and building the case for appropriate appeal and revenue recovery.
XSOLIS applies highly sophisticated Machine Learning algorithms to identify and prioritize denial resolution cases with strong clinical merit, most appropriate for appeal.
We deploy industry experts and denial resolution specialists with a combination of clinical, legal, and revenue cycle experience, including Auditors, CDI Specialists, and Case Managers.
Our denial management services technology defends admissions decisions to payers concurrently (while the patient is still in the hospital) and retrospectively (in the event of a denial).
No two cases (or corresponding appeal letters) are the same, so our analytics-based approach identifies denial resolution cases with demonstrated clinical merit.
Through our proprietary data management platform, complex denials are reviewed 3–5 times more efficiently than typical methods.
We offer actionable denial management analytics for key case metrics, including admitting or discharge diagnosis, procedure, length-of-stay, or downgrade and denial outcomes.
The intersection between payer, providers, and vendors is a junction fraught with uncertainty. Differences in regulation, variations in services provided, claim age, hospital, and systems in place pose barriers to this process, hampering successful resolution and reimbursement.
Mike Wyche
Revenue Management Supervisor, CRMC
655 Grassmere Park
Nashville, TN 37211
Call us: 855.371.0867
XSOLIS Health