Your Denial Data Isn't the Problem.
Knowing What to Do With It Is.
DenialsDX delivers a structured denial management assessment in 4 to 6 weeks at a fraction of the cost of traditional consulting. The Live Platform stays on after the assessment to drive implementation, governance, and sustainment. No generic dashboards. No binders that collect dust.
You Have the Data. You Don't Have the Plan.
Traditional consulting delivers strong output but costs $75k to $150k and takes 10 to 14 weeks. DenialsDX delivers the same structured methodology faster, at a fraction of the cost, with a live platform that keeps the work going.
| Traditional Consulting Big Four, boutique firms |
DenialsDX Same depth, different model |
|
|---|---|---|
| Root cause diagnosis | ✓ Manual analysis | ✓ Engine inference plus team validation |
| Prioritized action plan | ✓ Yes | ✓ Auto-generated with financial sizing |
| Workstream synthesis, not a list of findings | × Typically a list | ✓ Cross-finding synthesis into 8 workstreams |
| Structured discovery process | ✓ On-site interviews | ✓ Shadow guides, EMR checklists, interview kits |
| Implementation tracking | ✓ Available (additional cost) | ✓ Built into the Live Platform |
| Recommendations updated as performance changes | × Static deliverable | ✓ Engine re-runs on each new data cut |
| CMS and payer rule validation | × Analyst dependent | ✓ Checked against 26 payer profiles and CMS coverage policies |
| Cost | $75k to $150k engagement | A fraction of the cost |
| Time to actionable output | 10 to 14 weeks | 4 to 6 weeks |
From Data to Deployed Plan in 4 to 6 Weeks
No consultants on-site. No 12-week engagements. A structured, phased process that delivers consultant-grade output on a fraction of the timeline.
Structured Data Intake
A guided 8-stream intake package captures denials, write-offs, volumes, authorization events, appeals, client code mappings, organizational artifacts, and client root-cause samples. The engine ingests, normalizes, and flags data quality issues before analysis begins.
Phase 1 Findings
The engine produces initial findings with root cause hypotheses, financial sizing, confidence levels, and specific context gaps, the org-specific information the engine needs before it can prescribe deep recommendations.
Validation and Structured Discovery
Your team validates each finding. 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. Results flow back as organizational context.
Deep Recommendations, Then the Live Platform
The engine re-runs with full context and produces prescriptive, org-specific recommendations with owners, timelines, success criteria, and appeal templates. At handoff the Live Platform activates: copilot, implementation tracking, monthly committee scorecard, and autonomous engagement agents.
Two Ways to Engage.
Start with the Assessment to get the full diagnostic and action plan. Stay on the Live Platform to execute and sustain it.
Assessment
The complete diagnostic engagement.
4 to 6 week delivery. One-time engagement.
- Phased findings with structured discovery
- Org-specific denial root cause analysis
- Prioritized implementation roadmap
- Governance charter, committee scorecard, policies
- Executive readout deck and appeal template library
- Assessment deliverables package
Live Platform
Execution layer. Starts where the assessment ends.
Activates at assessment conclusion.
- Recurring data intake and engine re-runs
- AI Copilot grounded in your denial data
- Implementation tracking with owner-level cadence
- Monthly denial committee scorecard (auto-generated)
- Autonomous agents: engagement health, implementation coach, async discovery
- Governance toolkit and document workspace
- Payer intelligence across 26 payer profiles
The Numbers Behind Your Denial Problem
Built to Go Deeper Than Any Dashboard or Consultant
DenialsDX doesn't just report denial trends. It diagnoses root causes, checks payer-specific rules, validates against CMS coverage policies, synthesizes findings into workstreams, and produces recommendations tailored to your organization.
Payer and CARC+RARC Intelligence
The engine analyzes denial patterns across 26 payer profiles and the full X12 RARC registry, pairing CARC and RARC codes together to drive payer-specific appeal strategy, not just CARC counts.
CMS and Regulatory Validation
Recommendations are cross-referenced against CMS National and Local Coverage Determinations, Medicare Advantage clinical criteria, NCCI edits, OIG and RAC focus areas, so you know what's defensible.
Root Cause and Workstream Synthesis
Instead of handing you a list of 50 findings, the engine infers competing root cause hypotheses with confidence weights and synthesizes findings into eight workstreams tied to people, process, and technology.