Methodology

Consultant-Grade Assessment. A Fraction of the Time.

No consultants on-site. No 12-week engagements. A structured, automated process that produces the same output as a top-tier firm — delivered in 4 weeks for $10,000 flat.

The Core Difference

We Don't Leave a Binder Behind.
We Leave a Live Platform.

Traditional consulting produces a deliverable and walks out the door. DenialsDX produces the same deliverables — and then becomes your operating system for sustained revenue recovery.

4 Weeks, Not 12

Automated data analysis compresses what typically takes a consulting team weeks into days. You get answers faster without sacrificing depth.

$10k, Not $100k

No travel, no bench staffing, no project overhead. The same structured methodology at a price point designed for community hospitals.

It Keeps Working

The assessment plugs into the Platform tier, which stays live after delivery — continuously ingesting data, updating recommendations, and tracking execution.

The Timeline

Four Weeks, Start to Finish

Client time required: approximately 4–6 hours total, spread across departments. We do the heavy work; you provide context and attend the readout.

Week 1

Data Ingestion

Secure data transfer setup, denial exports, claim-level data ingestion, automated questionnaire generation based on your data profile.

Week 2

Qualitative Intake

Structured interviews with RCM, coding, clinical, and CDI leads. Workflow mapping, payer contract review, Epic build audit checklist.

Week 3

Synthesis & Gap Analysis

Quantitative and qualitative synthesis, root cause mapping, gap identification, opportunity sizing, prioritized initiative scoring.

Week 4

Readout & Handoff

Executive readout, deliverable package delivery, platform onboarding kickoff, implementation roadmap walk-through.

"Client time investment: ~4–6 hours total across all four weeks. No all-day workshops. No travel. We work around your team's schedule."

The Six Phases

A Complete Assessment Across Six Structured Phases

Each phase builds on the last — moving from raw data to a deployed action plan with assigned owners and timelines.

A

Phase A — Data Ingestion & Profiling

Secure ingestion of denial exports, remittance data, and claim-level feeds. Automated data profiling identifies completeness, quality issues, and initial pattern signals before human analysis begins.

Denial exports 835/837 data Claim-level feeds Data quality audit
B

Phase B — Qualitative Intake

Structured interviews with department leads across RCM, coding, CDI, clinical documentation, and managed care. Automated questionnaire generation based on your data profile ensures relevant, targeted conversations.

Structured interviews Workflow mapping Epic build review Payer contracts
C

Phase C — Quantitative Analysis

Automated statistical analysis across denial categories, payer performance, service line variance, denial age, and write-off patterns. Benchmarking against industry standards for mid-market community hospitals on Epic.

Denial rate trending Payer scorecarding Service line analysis Industry benchmarking
D

Phase D — Gap Analysis

Cross-reference of quantitative findings against qualitative intake to identify the people, process, and technology gaps driving denial volume. Root cause mapping at the payer, category, and workflow level.

Root cause mapping People / Process / Tech Opportunity sizing Priority scoring
E

Phase E — Prioritized Roadmap

Initiatives ranked by impact, effort, and urgency. Each initiative includes a description, recommended owner, estimated timeline, and success metrics — structured for handoff to an implementation team or tracked directly in the platform.

Impact/effort matrix Owner assignment Timeline estimates Success metrics
F

Phase F — Deliverables Package

All outputs compiled and delivered: denial opportunity report, implementation roadmap, project charter, policies & procedures, governance framework, and executive readout deck. The same package a top-tier consulting firm produces — auto-generated and ready to present.

Opportunity report Implementation roadmap Project charter Policies & procedures Governance framework Executive deck
What Happens After

The Assessment Doesn't End — It Becomes Your Operating System

At assessment conclusion, the platform tier activates. Your data stays live. Recommendations update automatically as your denial performance changes. Progress is tracked. Governance is built in.

Live FHIR Data Ingestion

Continuous data flow from Epic via FHIR. No more manual exports or stale snapshots — the platform reflects your current denial reality at all times.

Auto-Updating Recommendations

As your performance changes, recommendations reprioritize. What's fixed gets archived. What's emerging gets elevated. The roadmap stays current without manual refresh.

Progress & ROI Tracking

Every initiative on the roadmap is tracked. Recovery tied to completed actions, time to resolution trends, and financial impact dashboards give you the numbers your CFO needs.

Governance & Sustainment

Automated weekly reporting, policy library with version control, training material generation, and governance toolkit — so the work doesn't drift when attention moves elsewhere.

Ready to See What 4 Weeks Looks Like?

Request a demo and we'll walk through the methodology, your data requirements, and what the deliverable package looks like for a system like yours.