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Health System · Multi-Specialty

Health-System Payer Denial Management at Scale

Illustrative Revenue Cycle Automation Scenario. This scenario demonstrates how a healthcare organization could apply revenue-cycle automation. It is not presented as an actual customer result.

The Challenge

A health system with multiple facilities faced high denial volumes from diverse payer mixes. Each facility had its own billing team with different denial management processes. Network-level denial trends were invisible, and payer performance was not benchmarked across facilities. The lack of standardization led to inconsistent denial handling and missed recovery opportunities.

The Approach

Sarva connected to each facility's billing system, standardizing denial management workflows across the network.

Payer-specific denial rules were configured once and deployed to all facilities.

Network-level denial analytics dashboards were created with facility and payer drill-down.

AI-generated appeal letters were deployed for common denial categories, reducing appeal preparation time.

Illustrative Outcomes

Network denial rate

Illustrative reduction from 12% to under 5%

Appeal overturn rate

Illustrative improvement to above 70%

Facility benchmarking

Illustrative real-time visibility across all facilities

Outcomes are illustrative and do not represent actual customer results.

Key Lessons

Standardized denial workflows across facilities improve consistency and reduce network-wide denial rates.
Payer performance benchmarking identifies which payers are systemic denial sources.
AI-generated appeals dramatically scale appeal capacity for high-volume health systems.

See how this approach could work for your organization.

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