Methodology

Consultant-Grade Assessment. A Fraction of the Time.

A structured, phased process that produces org-specific denial management recommendations, not generic dashboards or binders that collect dust. 4 to 6 weeks. Four phases. Full lifecycle.

The Core Difference

Consultant-Grade Output.
A Fraction of the Cost and Timeline.

Traditional consulting costs $75k to $150k and takes 10 to 14 weeks. DenialsDX delivers the same structured output in 4 to 6 weeks. The Live Platform keeps the work alive after the assessment concludes.

4 to 6 Weeks, Not 12

Structured intake plus an engine that runs 17 steps per analysis compresses what typically takes a consulting team weeks into days. You get answers faster without sacrificing depth.

A Fraction of the Cost

Traditional consulting engagements run $75k to $150k. DenialsDX delivers the same structured methodology at a price designed for community and mid-market hospitals.

It Keeps Working

The assessment plugs into the Live Platform, which stays on after delivery. The engine re-runs on each new data cut. Autonomous agents keep discovery, implementation, and engagement health on track.

The Timeline

4 to 6 Weeks, Start to Finish

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

Week 1

Structured Intake and Profiling

Secure data transfer across the 8-stream intake package (denials, write-offs, volumes, authorization events, appeals, client code mappings, organizational artifacts, and root cause samples). The router auto-detects file shapes; the validator flags referential integrity issues before analysis. The engine runs initial profiling.

Week 2

Phase 1 Findings and Validation

The engine produces initial findings with root cause hypotheses, financial sizing, and specific context gaps. Your team validates each finding: confirm, reject, or add context notes. Structured interviews with RCM, coding, CDI, and managed care leads fill in org-specific context.

Week 3

Structured Discovery

For each validated finding the engine generates a Discovery Package with shadow guides, EMR checklists, interview guides, and policy reviews. Your team conducts targeted discovery. Async self-service discovery is available when department leads can't align schedules.

Weeks 4 to 6

Deep Recommendations, Readout, Platform Handoff

The engine re-runs with full organizational context and produces deep recommendations with owners, timelines, success criteria, and appeal template references. Executive readout, full deliverables package, governance charter, monthly committee scorecard, and platform onboarding with agents activated.

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

The Four Phases

The Four-Phase Engagement Model

Each phase builds progressively, moving from data to findings to org context to prescriptive recommendations. This is how consultant-grade depth gets delivered without consultants.

1

Phase 1: Findings

The engine analyzes your denial data and produces initial findings: identified denial patterns with root cause hypotheses, financial sizing, and confidence levels. Findings are NOT recommendations yet. Each finding includes "context gaps", specific pieces of organizational information the engine needs before it can produce prescriptive recommendations.

Denial pattern identification Root cause hypotheses Financial sizing Context gap identification
2

Phase 2: Client Validation

Your team reviews each finding and provides validation: confirm, reject, or add context notes. This is where the engagement becomes org-specific. Your team's operational knowledge gets layered onto the quantitative analysis before any prescriptive work begins.

Finding review Context notes Org-specific validation Priority confirmation
3

Phase 3: Discovery

For each validated finding, the engine generates a Discovery Package, a research kit that includes shadow guides, EMR checklists, structured interview guides, and policy review templates. Your team conducts targeted discovery in person or through async self-service invites. The results flow back into the engine as organizational context.

Shadow guides EMR checklists Interview guides Policy reviews Async self-service Org context capture
4

Phase 4: Deep Recommendations

With full organizational context, the engine re-runs and produces prescriptive, org-specific recommendations. Each recommendation includes a specific action, assigned owner, implementation timeline, success criteria, financial opportunity sizing, and appeal template references where relevant. Cross-finding synthesis groups 30 to 50 findings into eight workstreams the committee can actually act on.

Prescriptive actions Owner assignment Timeline estimates Financial sizing Success criteria Workstream synthesis
Deliverables

What You Walk Away With

The assessment produces a full deliverable package across assessment outputs, discovery toolkits, and operational resources: everything you need to understand the denial picture and execute the roadmap.

Assessment Deliverables

Findings report, deep recommendations, prioritized implementation roadmap, financial opportunity model, executive readout deck, and the full appeal template library mapped to your CARC and RARC patterns.

Discovery Toolkit

Finding validation forms, per-finding discovery packages (shadow guides, EMR checklists, interview guides, policy reviews), a data request package that adjusts to what you've submitted, and discovery readiness scorecard.

Operational Resources

Denial prevention playbook, CARC quick reference, 26 payer denial profiles, implementation tracker, governance committee charter, and the first monthly denial committee scorecard ready for the packet.

What Happens After

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

At assessment conclusion, the Live Platform activates. Recurring data cuts flow through the engine. Recommendations reprioritize as performance changes. A Copilot keeps the work moving forward. A set of autonomous agents runs discovery follow-ups, weekly implementation check-ins, and a monthly executive briefing on their own cadence.

Recurring Data Intake and Engine Re-Runs

The 8-stream intake reopens on a cadence you set. Each new data cut flows through the full 17-step pipeline. Trend detection surfaces emerging patterns before they become backlogs.

Auto-Updating Recommendations

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

Autonomous Engagement Agents

Engagement Health Monitor flags stalled phases daily. Implementation Coach checks in weekly by owner. Report Agent produces a monthly executive briefing on its own. Write actions require approval.

Reporting Cadence and Governance

Weekly intelligence digest every Monday (recipient-controlled), monthly denial committee scorecard as PDF plus XLSX, policy and document workspace, and the full governance toolkit, so the work doesn't drift when attention moves elsewhere.

Ready to See What 4 to 6 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.