Problem Statement

Health systems must manage a massive volume of unstructured payer correspondence arriving by mail, fax, and portal. Every letter must be read, indexed, and routed before downstream teams can act, and doing this manually is slow and prone to backlog. Payers send denial letters with or without a corresponding 835, so accounts must be reconciled to ensure each denial is worked appropriately. Because of these processing delays, denials frequently go unworked, leading directly to revenue leakage.

Automation Solution

This automation extracts key details from paper denial letters using document understanding, reconciles them against existing denial records, and posts the information directly into the EMR to improve denial management and reduce manual entry.