RCM manager

Where should I intervene to unblock teams?

Next-best action: Rebalance denials queue by re-allocating 15 Aetna denials to Specialist Ortiz.

Revenue at Risk

$1,250,000

Unassigned Queues

9 tasks

Team Throughput

84 outcomes/day

Payer memory

Average recovery time: 36.0 hours. Denial patterns tracked: 4.

What works: lead with claim history and generated claim timeline.

Payer memory

Average recovery time: 37.2 hours. Denial patterns tracked: 5.

What works: lead with claim history and generated claim timeline.

Payer memory

Average recovery time: 37.2 hours. Denial patterns tracked: 5.

What works: lead with claim history and generated claim timeline.

Payer memory

Average recovery time: 18.0 hours. Denial patterns tracked: 2.

What works: lead with implant reimbursement and generated claim timeline.

Payer	Problem	Resolution	Result	Memory
D	AR Follow-Up	Follow-up completed	$1,312.00	Terrence Cole chose 'advance follow-up' and produced 'Follow-up completed'.
unassigned	Missing Implant Supply Charge	Charge action recorded	$422.40	Nina Patel chose 'correct charge' and produced 'Charge action recorded'.
D	Appeal	Appeal path documented	$1,312.00	Terrence Cole chose 'approve recommendation' and produced 'Appeal path documented'.
D	Ar 120 Plus	Follow-up completed	$1,312.00	Marcos Vega chose 'advance follow-up' and produced 'Follow-up completed'.
D	Documentation Missing Medical Necessity	Coding review documented	$576.00	Nina Patel chose 'approve correction' and produced 'Coding review documented'.
unassigned	Coding Review	Coding review documented	$208.00	Nina Patel chose 'approve correction' and produced 'Coding review documented'.
D	Medical Necessity Denial	Appeal path documented	$1,312.00	Terrence Cole chose 'approve recommendation' and produced 'Appeal path documented'.