One-page executive summary · Revenue cycle

Healthcare Denial Review

Governed denial triage: denials entered or imported, grouped by category and aging, reviewed and published as a client report.

THE PROBLEM

Denials pile up faster than the team can work them.

Every payer has different rules and deadlines.

Leaders cannot see which issues cost the most.

THE VALUE

Work the denial backlog in priority order

Fewer missed appeal deadlines

Consistent documentation for every appeal decision

What it does

  • Analyst intake or denial-file CSV import
  • Grouping by denial category and aging
  • Clearly labelled synthetic payer and denial-code rule set
  • Appeal deadlines flagged for human review
  • Dollar amounts as supplied, never an estimate of recoverable revenue
  • Branded client report and PDF, weekly-review Copilot
Best-fit clientsArizona health systems, physician groups, revenue-cycle and billing firms
RolesAnalyst, Reviewer, Publisher, Client
PricingPilot pricing on request
StatusLive pilot
GovernanceHuman review, versioning, audit trail

How a pilot runs

  1. Week 1 · Set up

    Accounts and roles created; synthetic or approved sample data loaded.

  2. Weeks 2–4 · Run

    Your team runs the daily flow on real-shaped work with TSM support.

  3. Week 5 · Decide

    Review results together and decide on a monthly service.

Clinical conclusions and recoverable revenue are never assessed. Nothing submits an appeal or contacts a payer or provider. Designed with HIPAA safeguards in mind; pilots use synthetic or de-identified data only. A BAA and security review are required before any PHI is processed. Contact torreyw94@tsmatter.com.