Gather appeal letters and supporting documentation and submit them to the payer via Availity to overturn denied claims.
DOMAIN
Revenue Cycle Back
FUNCTION
Denials & Appeals
Category
Appeal Creation and Submission
Status
Status Unknown
AUTHORING ORGANIZATION
Baptist Memorial (BMHCC)
PERFORMANCE METRIC
Denial Write offs
Automation Tool
UiPath
TECHNOLOGIES
RPA
Applications
EPIC
Availity
HB | PB
N/A
Problem Statement
A denied claim only becomes recoverable revenue if someone assembles the appeal and submits it before the filing deadline. Doing this manually means pulling the appeal letter and supporting documentation together, logging into the payer portal, and keying the submission for each denial - slow, repetitive work that backlogs easily. While appeals sit unsubmitted, denials age toward the appeal deadline, and any that miss the window become permanent write-offs on revenue the organization had every right to recover.
Automation Solution
This automation gathers appeal letters and supporting documentation and submits them to the payer via Availity to overturn denied claims.
Automation Resources
PDDs, Process Flows, Presentations, and Assessments
Timely Filing Appeals BCBS Availity - Process Flow
Problem Statement
A denied claim only becomes recoverable revenue if someone assembles the appeal and submits it before the filing deadline. Doing this manually means pulling the appeal letter and supporting documentation together, logging into the payer portal, and keying the submission for each denial - slow, repetitive work that backlogs easily. While appeals sit unsubmitted, denials age toward the appeal deadline, and any that miss the window become permanent write-offs on revenue the organization had every right to recover.
Automation Solution
This automation gathers appeal letters and supporting documentation and submits them to the payer via Availity to overturn denied claims.
Automation Resources
Timely Filing Appeals BCBS Availity - Process Flow
Related Automations
Appeal Submission - Availity
Comments