Claims Denied for Lack of Medical Necessity

$1M recovered by overturning 92% of medical necessity denials in 6 months

Key issues: documentation–policy mismatch, coding gaps, outdated authorizations

Fix: align documentation with payer rules + smarter templates & training

Automation: faster appeals (61 → 19 days) and 40% less workload

Real-time: PA updates stopped denials before they happened

Result: 50% fewer future denials and stable revenue