SmarterDx has launched SmarterDenials, an AI-driven appeals solution that is designed to assist hospitals in combating operational disruptions and revenue loss.
Over the past five years, there has been a 20% surge in payer denials, and approximately 15% of all claims were initially denied yesterday, resulting in over $20bn spent annually by hospitals to overturn them.
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SmarterDenials offers a timely and efficient response to this growing challenge.
Hospitals currently face a time-consuming process when dealing with denials, often receiving them via fax or mail.
SmarterDenials streamlines this by allowing hospitals to upload denied claims, after which the solution quickly identifies relevant evidence and analyses patient records.
This process results in the generation of comprehensive appeal letters, complete with case-specific clinical evidence and coding references, within minutes.
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By GlobalDataUniversity of Arkansas for Medical Sciences (UAMS) CEO Dr Cam Patterson said: “At UAMS, we’ve seen how rising denials adversely affect our bottom line, which ultimately impacts our ability to invest more in patient care. With AI, we can create strong appeals in a fraction of the time, which is a game-changer.”
SmarterDenials is built on SmarterDx’s proprietary clinical AI platform and complements their existing SmarterPrebill solution.
It is specifically designed to tackle complex denials, such as Diagnosis-Related Group (DRG) downgrades and level of service disputes.
SmarterDx CEO and co-founder Michael Gao said: “With SmarterDenials, we’re giving hospitals the tools to fight denials quickly and effectively.
“By helping hospitals better respond to the rising tide of denials and secure the reimbursement they deserve, SmarterDenials helps them focus on what they do best: serving their patients and communities.”
The SmarterDenials solution is available as part of the SmarterDx platform, which is already in use by more than 20 health systems to enhance revenue integrity.
