Prevent Denials. Prioritize Recovery. Maximize Revenue.
AI-powered decision intelligence for healthcare providers
Identify denial risk before submission and prioritize high-impact recovery opportunities while fitting into existing RCM workflows.
The Problem
Denial management remains reactive and expensive.
Despite significant investment in RCM platforms, payer edits, and clearinghouse workflows, claim denials continue to represent a persistent source of revenue leakage for provider organizations.
Across industry forums and peer discussions, revenue cycle leaders consistently highlight common challenges:
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Limited early visibility into which claims are likely to be denied
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Increasing payer variability and complex, shifting edit requirements
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Denial workflows that surface issues only after submission
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Difficulty prioritizing recovery efforts across large denial volumes
As a result, teams are often forced to manage denials by volume rather than by value, spreading effort across repetitive, low-yield rework while higher-impact recovery opportunities compete for attention.
How Denova Works
Denova introduces an intelligence layer across the claims workflow, before and after claim submission to support more informed decision-making.
Pre-Submission Risk Identification
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Identifies claims with elevated denial risk
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Surfaces payer-specific and historical patterns
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Enables proactive correction prior to submission
Post-Denial Recovery Prioritization
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Prioritizes denied claims based on expected recovery impact
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Directs staff effort toward the most meaningful appeal opportunities
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Minimizes time spent on low-probability recoveries
Works with your existing RCM systems — no replacement required
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Integrates alongside clearinghouses and RCM platforms
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No system replacement or workflow disruption
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Leverages standard claim data (837 / 835)
Operational Outcomes
Denova functions as a decision-support layer where teams act on insights, not volume.
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Surfaces denial risks before submission to reduce preventable rework
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Helps teams focus on high-impact, time-sensitive recovery opportunities
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Reduces effort spent on low-yield denials and unnecessary follow-ups
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Brings consistency to prioritization across claims, teams, and payers
Why Now — Revenue Cycle Needs a Decision Layer
Complexity is increasing — but workflows haven’t kept up.
Denials are rising, payer rules vary widely, and teams are still relying on manual queues.
At the same time, most tools focus on automation and reporting — not on what to prioritize.
As a result:
- High-value claims are delayed
- Time-sensitive opportunities are missed
- Teams spend effort on low-yield work
RCM systems manage workflows — they don’t guide decisions.
Denova bridges this gap by helping teams move from volume-based worklists to impact-driven prioritization.
Who It’s For
Revenue cycle leaders and teams managing denial risk and recovery at scale.
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Hospitals and health systems
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Organizations with high denial volumes
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RCM teams focused on efficiency and focus
Pilot Collaboration
Validate Denova in real-world revenue cycle workflows
Denova is working with healthcare organizations and RCM teams to validate denial prevention and recovery prioritization in real-world workflows.
Lightweight pilot approach
- Minimal implementation
- Fits existing RCM workflows
- Defined validation goals and success measures
Pilot partners can evaluate:
- Earlier identification of potential denial risks
- Smarter prioritization of recovery opportunities
- More effective use of RCM team resources
Interested in exploring a pilot?
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Connect with Denova →