How it works

A clear path from receipt to resolution.

Denial work can involve many steps. The important thing is to keep the denial active and visible until the work is explicitly resolved.

The workflow

Each step moves the work forward.

Information requests, appeals, and follow-ups are actions—not automatic closure. The denial remains in the active workflow while next steps are pending.

  1. 01

    Denial received

    The denial enters the active work queue and remains visible.

  2. 02

    Request information

    Identify the missing details and request what is needed.

  3. 03

    Follow up

    Keep the work active while waiting for the requested information.

  4. 04

    Information received

    Review the new information and determine the next action.

  5. 05

    Appeal submitted

    When appropriate, submit an appeal and track the pending payer decision.

  6. 06

    Follow up with payer

    Keep the denial active while the payer decision is pending.

  7. 07

    Payer overturns denial

    Record the outcome and confirm whether any further action remains.

  8. 08

    Explicitly resolve

    Close the denial only when the work is deliberately marked resolved.

Make resolution intentional.

Explore how a structured workflow could support your denial operations.

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