Case Study

Denials Management

AI Appeals Recover $5.6M+ from Complex Clinical Denials in 2 Months
Download Case Study
Aspirion's Services

Partnership Powered by Results

QUICKER COLLECTIONS

$5.6M+

recovered in 2 months using AI-powered appeals

FIRST-LEVEL APPEAL SUCCESS

$4.8M

collected from first-level appeals (AI-written, human-verified)

EFFICIENCY AT SCALE

86%

of collections from first-level appeals

RESULT

Quicker Collections:

  • Recovered $5.6M in collections within 2 months of appeal submission

First-Level Appeal Success:

  • Collected $4.8M in two months from overturned denials after only one appeal submission—demonstrating the power of targeted, documentation-driven appeals

Efficiency at Scale:

  • 86% of collections from AI-generated first-level appeals

CHALLENGE

Increased Clinical Denials:

  • Complex clinical denials had surged, creating unresolved balances and significant financial pressure

Backlog Accumulation:

  • A growing denials backlog inflated active accounts receivable and delayed critical reimbursements

Resource Constraints:

  • Internal teams lacked capacity to manage appeal volume and complexity, prolonging resolution timelines and increasing financial risk

SOLUTION

Aspirion’s denials management services, which includes our DocIQ, AI-powered technology, addressed the mounting denials backlog:

AI-Generated, Human-Verified Appeals:

  • Collected $5.6M+ in two months, accelerating dispute resolution

Clinical Focus:

  • Prioritized Level of Care-Patient Status denials with AI-generated, payer-specific clinical justification

Scalable Solution:

  • AI-powered appeal generation at scale, plus human follow-up through account resolution—without adding internal staff or administrative burden

“I love Aspirion. They are great. I think the AI-generated appeal letters for DRG downcoding that Aspirion is doing are based on some really good technology and content, and there is more to come.”

VP/Other Executive
Denials Management Client

About the Provider

  • A leading not-for-profit health system in the Southeast with 10+ hospitals and over 300 medical offices, nationally recognized for high-quality care and commitment to community health.