Denial Management Prioritization and Prioritization | Sift Healthcare
AI-Optimized Denial Management & Prioritization
Intelligent Post-Bill Revenue Recovery
Payer tactics are constantly changing. RevProtect optimizes denial management, helping hospitals and health systems recover more, faster, by prioritizing the recovery work that actually moves cash.
- Faster cash
- Fewer wasted touches
- Measurable ROI for existing staff
- Improved cash forecasting
Download a Recovery Case Study
Denials Are Inevitable. Wasted Effort Is Not.
Denials now cost the average hospital ~3.3% of net patient revenue. For the average hospital, that’s nearly $5M walking out the door. And reworking them costs an additional ~$118 per hospital-based claim:
- Too many denials and downgrades to work with limited Patient Financial Services capacity
- No reliable way to know which denials are worth pursuing
- Poor visibility into when payer follow-up will actually change outcomes
- Limited insight into denial-driven cash impact
- Disconnected analytics across denials, work effort, and expected recoveries
RevProtect applies payer-specific intelligence and machine learning to optimize recovery when denial prevention isn’t enough, enabling hospitals to understand which denials are worth working, when payers are most likely to respond and where staff effort will actually convert to cash.
How RevProtect Optimizes Denial Management:
RevProtect provides detailed visibility into reimbursement performance across the full denial and payment lifecycle.
Denial Prioritization by Recovery Likelihood
Not all denials are equal. RevProtect predicts overturn probability and scores actionability, so teams focus on the denials most likely to convert to cash.
Predicted Payer Response & Timing
Machine learning identifies when a payer is most likely to respond on a specific claim, reducing wasted follow-ups and accelerating cash.
Workflow-Embedded Denial Worklist Prioritization
Recovery intelligence can be delivered directly into existing denial, appeal, and follow-up workflows — or accessed through Sift's user portal.
Cash Forecasting
Understand expected cash outcomes based on current denial mix, payer behavior, recovery performance, claim agings, and recent submissions — not static aging reports.
Root Cause Identification
Provides analytics that explain “why” behind prioritization (payer behavior, denial drivers, documentation /coding/DRG considerations), not just a score.
Recommendations
Account-specific recommendations to overturn denials, tied to user activity + Insight Reports that show expected recoveries, timing, and performance by payer/service line/denial pattern.
By establishing a clear, data-driven view of payer behavior and reimbursement risk, health systems armed with RevProtect are equipped to proactively prevent adverse payment outcomes.
RevProtect intelligence powers:
- Adverse payment outcome predictions
- Actionable recommendations that guide prevention and recovery
- Validation and learning that measures impact and continuously improves performance
Optimized Denial Management
Do More With the Team You Have
RevProtect helps revenue cycle leaders:
- Reduce low-value touches
- Shorten time-to-cash
- Increase recovery rates without adding headcount
- Tie daily work directly to financial outcomes
Talk with us about how revenue recovery intelligence fits into your RevProtect strategy.
Request a Revenue Recovery Optimization Review
Aligned to Outcomes, Not Promises
RevProtect is available through a performance-based engagement model designed to align incentives and reduce risk. Sift partners directly with health systems to tie success to measured reductions in denials and adverse payment outcomes (not activity, licenses, or usage).
Talk with us about whether a performance-based model makes sense for your organization.
Justin Nicols
Founder & CEO
A leading industry expert in data analytics technology and has an extensive background in corporate finance and investment banking. Prior to founding Sift, Justin served on the executive team of venture backed ad technology company, and an e-commerce technology company.