Acute Care Hospital in Pennsylvania — Denial Management Success
Reduce avoidable denials, draft appeals in minutes, and see outcomes tied to 835 remits and cash.
Customer
Large acute care hospital in Pennsylvania
A multi campus hospital with a mix of commercial and government payers and denial inventory measured in the millions of dollars.
The Challenge
Avoidable and medical necessity denials created measurable leakage
- 1Authorization, missing documentation, coding edits, and LCD or NCD related issues
- 2Medical necessity denials that required fast, evidence based appeals
- 3Manual tracking of appeal outcomes that made it hard to tie work to 835 remits and posted cash
Solution
Neurex AI in production
Pre-bill risk and edits
Denial risk scoring with LCD or payer policy edit intelligence to prevent avoidable denials.
Clean resubmissions
Automated resubmission workflows and clean claim generation when fixes are available.
Appeal drafting
Ingests payer denial letters and produces ready to edit drafts with page linked evidence and guideline citations.
Closed loop outcomes
Joins appeals to 835 remits and posted dollars so leaders see overturn rates and financial impact.
Production results
Measured outcomes at scale
Times measured once denial letter and chart are available.
Impact
What leaders see
How to think about it
"Think of Neurex AI as an extension of your team. It feels like a thousand digital teammates clearing routine work so your experts focus on higher value care and improvement."
— Neurex AI
See it working on your denials
We can align scope, data, and KPIs in a 30 minute working session and stand up production phases quickly.