What are denial management services and how can they help my hospital?

Denial management services combine expertise and tools to recover revenue from denied claims. They streamline appeals, support defensible decisions, and help reduce future denials. When powered by AI, these services improve speed, accuracy, and recovery rates with less effort from your team.

How do denial management solutions improve revenue cycle performance?

Denial management solutions use clinical and financial data to identify appealable cases, generate strong justifications, and resolve denials faster. These tools reduce administrative burden and support continuous performance improvement through insights and trends in denial patterns.

What should I look for in a denial resolution tool?

Look for a denial resolution tool that uses machine learning, integrates with clinical systems, and delivers case-level insights. The best tools prioritize high-value appeals, speed up reviews, and provide actionable data so you can prevent denials from recurring.

How do denials management services reduce administrative burden?

Denials management services reduce administrative workload by handling appeals from start to finish. With skilled clinical and legal experts managing each case and AI supporting review prioritization, your internal teams stay focused on patient care.

How is a denial management service different from in-house appeals processing?

A denial management service offers dedicated, outsourced professionals who specialize in overturning complex denials. Backed by data and analytics, these services often outperform internal efforts in speed, efficiency, and recovery rate.

What is denial resolution and why is it important to get it right?

Denial resolution is the process of appealing denied claims and securing payment. Doing it well improves cash flow, reduces bad debt, and supports fairness in clinical decision-making. The right approach protects both your bottom line and your staff’s time.

Denial Management Solutions | Xsolis | Reduce Denials, Maximize Reimbursements

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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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