REVENUE INTEGRITY INSIGHTS FOR HOSPITALS AND HEALTH SYSTEMS

Reduce Revenue Leakage and Improve Denial Management Operations

Leverage Xsolis’ AI-powered medical necessity data to get a full view of your organization’s end-to-end denial trends to reduce denied revenue, avoid inappropriate downgrades and mitigate the risk of inappropriate paybacks or lost income.

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Beyond Traditional Denial Reporting

Revenue Integrity Insights Impacting Operations Across Your Organization

Align Care Decisions with Proper Reimbursement

Optimize Concurrent Authorization Processes

Achieve the appropriate level of care AND the appropriate reimbursement with Care Level Score™ (CLS™)-powered insights.

  • Prioritize appeal and P2P efforts  
  • Increase appropriate reimbursement with end-to-end denial insights 
  • Leverage objective data to optimize claims and denials processes 
Ensure Appropriate Payments

Denial Insights that Drive Mid-Revenue Cycle Integrity

AI-driven objective medical necessity data and end-to-end denial data in one place help teams capture additional reimbursement. 

  • Prioritize appeal and P2P efforts
  • Ensure appropriate reimbursement and reduce post claim denial risk
  • Determine appropriate billing status 
Reduce Payer Friction

Support Managed Care Relationships and Resolutions   

Revenue Integrity Insights delivers denial insights and payer trends to recover appropriate revenue and enhance payer relationships. 

  • Reduce unnecessary denials with objective data and payer trends
  • Identify opportunities for better alignment and reduced friction
  • Objective data supports payer relationships and resolutions 
Drive Proactive PA Efficiencies

End-to-End Visibility of P2P Outcomes and Final Rulings

Leverage denial trends and outcomes to streamline and prioritize Physician Advisor activities.  

  • Historical data-based outcomes drive future prioritization
  • Achieve more timely revenue
  • Enable proactive PA review and statusing  
Align Care Decisions with Proper Reimbursement Ensure Appropriate Payments Reduce Payer Friction Drive Proactive PA Efficiencies

Optimize Concurrent Authorization Processes

Achieve the appropriate level of care AND the appropriate reimbursement with Care Level Score™ (CLS™)-powered insights.

  • Prioritize appeal and P2P efforts  
  • Increase appropriate reimbursement with end-to-end denial insights 
  • Leverage objective data to optimize claims and denials processes 

Denial Insights that Drive Mid-Revenue Cycle Integrity

AI-driven objective medical necessity data and end-to-end denial data in one place help teams capture additional reimbursement. 

  • Prioritize appeal and P2P efforts
  • Ensure appropriate reimbursement and reduce post claim denial risk
  • Determine appropriate billing status 

Support Managed Care Relationships and Resolutions   

Revenue Integrity Insights delivers denial insights and payer trends to recover appropriate revenue and enhance payer relationships. 

  • Reduce unnecessary denials with objective data and payer trends
  • Identify opportunities for better alignment and reduced friction
  • Objective data supports payer relationships and resolutions 

End-to-End Visibility of P2P Outcomes and Final Rulings

Leverage denial trends and outcomes to streamline and prioritize Physician Advisor activities.  

  • Historical data-based outcomes drive future prioritization
  • Achieve more timely revenue
  • Enable proactive PA review and statusing  

"RII allows for non-clinical revenue cycle leaders and clinical leaders to communicate using a common language and common data set. I foresee how we can internally share with one another how each identifies opportunities via the tool and how we might work together on improving processes and closing gaps."

- Director of Denial Recovery

A Multi-State Integrated Health System Client

Resources

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Optimize Revenue Integrity & Improve Payer Alignment with AI

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Learn how Revenue Integrity Insights can support and raise the standard of your organization.

 

Frequently Asked Questions

Revenue integrity solutions help healthcare organizations prevent revenue leakage and ensure appropriate reimbursement. Dragonfly Revenue Integrity Insights combines revenue cycle analytics with the objective Care Level Score to surface missed inpatient conversion opportunities, align clinical merit with status, and drive payer collaboration that reduces denials and underpayments.

Revenue cycle intelligence transforms clinical and financial signals into actionable insights that optimize reimbursement. Dragonfly Revenue Integrity Insights unifies the Care Level Score with LOS and outcome data to reveal status confidence, underpayment drivers, and automation opportunities that improve revenue cycle integrity and denial prevention.

Effective revenue cycle analytics detect risk upstream and guide targeted interventions. Dragonfly Revenue Integrity Insights tracks pre-claim and concurrent denial trends, ties them to the Care Level Score and LOS, and pinpoints root causes. Teams use these insights to standardize processes, strengthen documentation, and collaborate with payers to prevent denials.

Healthcare revenue integrity software provides analytics that connect clinical validity with financial outcomes. Dragonfly Revenue Integrity Insights delivers objective, AI-powered visibility into missed IP reimbursement, payment risk, and denial trends, enabling revenue cycle teams to prioritize actions, improve revenue capture, and strengthen payer collaboration.

Revenue integrity aligns clinical documentation, coding, medical necessity, and billing to protect appropriate payment. With revenue cycle intelligence, Dragonfly Revenue Integrity Insights identifies missed IP reimbursement, pre-claim and concurrent denial trends, and process gaps so leaders can act earlier and reduce payment risk across the mid revenue cycle.

Mid-revenue cycle solutions connect utilization review, clinical documentation, coding, and billing quality. Dragonfly Revenue Integrity Insights provides visibility into alignment or misalignment between clinical merit and status, highlights conversion opportunities, and quantifies payment risk, so organizations can intervene before claims finalize and recover appropriate reimbursement.

A revenue integrity manager oversees processes that link medical necessity, documentation, coding, and billing accuracy. With healthcare revenue integrity software like Dragonfly Revenue Integrity Insights, managers monitor conversion opportunities, status confidence, denial patterns, and underpayments to drive organization-wide improvements and protect compliant, appropriate reimbursement.