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

Effective revenue cycle analytics detect risk upstream and guide targeted interventions. Dragonfly Revenue Integrity Insights tracks case data and concurrent denial trends, ties them to the proprietary Care Level Score (CLS) and Length of Stay, and helps pinpoints root causes. Healthcare revenue cycle teams use these insights to standardize processes, strengthen documentation, and collaborate with payers.