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Those tools are built for transaction processing and reporting — they surface denial data but don't tell you what to do about it. DenialsDX works alongside your existing stack. We ingest data from your current systems (including exports from those platforms) and layer on the diagnostic and action planning capabilities they don't provide. Most clients continue using their existing tools after the assessment; DenialsDX becomes the layer that drives execution on top of the data those tools already surface.

The Platform tier's live FHIR data ingestion is optimized for Epic. The Assessment tier (Tier 1) works with any system that can export denial and claims data — which includes virtually every major EHR and RCM platform. If you're not on Epic, we'll use standard data exports for the assessment and discuss your options for the platform tier during the readout. A significant portion of our target market is mid-market community hospitals, the majority of whom are on Epic, but we don't turn anyone away based on EHR.

For the assessment, we typically need 12–24 months of denial data at the claim line level, remittance (835) files, and basic charge/encounter data. We'll provide a specific data request document after kickoff based on your EHR environment. Most systems can produce this data within 1–2 business days. We handle all ingestion, normalization, and analysis — your team's involvement in the data phase is minimal.

A traditional consulting firm assigns a team, conducts on-site workshops, and delivers a report — typically over 10–14 weeks for $75–150k. The deliverable is strong, but it ends at delivery. There's no mechanism to track whether the recommendations are being executed or whether performance is improving. DenialsDX produces the same structured output (and in many cases, more comprehensive analysis) in 4 weeks for $10,000 — and then the platform tier keeps the work alive after the assessment concludes. You get the deliverables of a consulting engagement and the continuity of a SaaS platform.

The client time is primarily structured interviews in Week 2 — typically 3–4 focused conversations with department leads (RCM director, coding lead, CDI lead, managed care lead) lasting 45–60 minutes each. Week 4 is the readout, typically a 90-minute session with the CFO, RCM director, and any relevant leadership. The data transfer in Week 1 is largely handled by IT and usually involves submitting standard exports — most clients spend under 1 hour on it. No all-day workshops, no multi-day on-site visits.

Yes. Tier 1 is a standalone engagement. You pay the flat fee, receive the full deliverable package, and you're under no obligation to continue to the platform tier. Many clients use the assessment as a foundation and then decide to activate the platform once they've seen the quality of the output. The assessment is designed to stand on its own — the roadmap and deliverables are actionable without the platform. The platform just makes execution significantly more efficient.

Platform pricing is based on bed count and data volume. Community hospitals in the 100–300 bed range typically fall at the lower end of the range; larger systems (300–500+ beds) fall higher. We'll confirm pricing during the assessment readout based on your specific environment. There are no per-user fees, and the full feature set is available at both price points.