Is this an actual customer result?

In-House RCM Department · Multi-Specialty

Internal RCM Team Denial Appeal Automation

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

An in-house RCM team at a multi-specialty clinic was only appealing 30% of appealable denials due to capacity constraints. Writing appeal letters took 30–60 minutes each, and the team prioritized high-dollar claims, leaving lower-value denials unappealed. Total recoverable revenue from unappealed denials was significant.

The Approach

Sarva's AI appeal letter generation was deployed for all appealable denials, not just high-value claims.

Letters were auto-generated with clinical citations and payer-specific formatting, then reviewed by staff in under 5 minutes each.

Appeal tracking was automated, with status monitoring and outcome analytics.

Root cause analysis was enabled to identify denial patterns that could be prevented upstream.

Illustrative Outcomes

Appealable denials appealed

Illustrative increase from 30% to above 85%

Appeal turnaround

Illustrative reduction from 2 weeks to 48 hours

Revenue recovered from appeals

Illustrative significant increase

Outcomes are illustrative and do not represent actual customer results.

Key Lessons

AI-generated appeal letters scale appeal capacity beyond high-value claims, recovering revenue from smaller denials.
5-minute review vs. 60-minute drafting dramatically increases throughput.
Appealing all appealable denials, not just high-value ones, recovers significant cumulative revenue.

See how this approach could work for your organization.

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