Introduction

Denials Management is a module in Oracle Autonomous Reimbursement.

This module displays a list of all denials from the source Patient Accounting system that the Denial agent has analyzed for follow-up. For all denials, the agent provides a root-cause analysis and suggested resolution. For some denials, the agent composes appeal packets for your review. For other denials, you can determine whether to close the denial in Oracle Autonomous Reimbursement and follow-up in your source Patient Accounting application or override the Denial agent's suggestion to create an appeal packet.

When you select a denial to view details, you can see that the agent provides an analysis of its root cause along with a recommended solution. If an appeal packet is available, the record also contains an appeal letter and supporting clinical documents created by the Denial agent for use in denial appeals. You can review and update these packets as needed, download them, and update the denial status in Oracle Autonomous Reimbursement.

Note:

The Denial agent is compatible with Cerner Patient Accounting.