UCG SOLUTIONS
Don’t just work denials. Remove the reasons they happen.
UCG approaches denials as both a recovery problem and an upstream process signal. Teams categorize, prioritize, resolve and trend denials while tracing recurring issues to registration, authorization, documentation, coding, billing or payer behavior.
Scope of support
- Denial inventory segmentation
- CARC/RARC and payer-specific categorization
- Root-cause analysis
- Technical and clinical denial review
- Coding and documentation review
- Corrected claims and resubmissions
- Appeal preparation and follow-up
- Timely-filing and COB issue management
- Payer trend analysis
- High-dollar denial prioritization
- Prevention worklists and feedback loops
Common risks and triggers
- Authorization denials
- Eligibility and coverage denials
- Coding and modifier denials
- Medical necessity and clinical denials
- Timely filing
- Duplicate or bundling edits
- COB and demographic issues
- Non-covered services
- Payer-specific administrative denials
HOW THE WORK MOVES
Follow this capability through its operating steps.
Select each stage to inspect the task, the issue to watch, an example action and the accountable reviewer.
WORKFLOW EXPLORER
Denial to prevention loop
A denial is routed from reason classification to appropriate recovery and upstream prevention.
SELECTED STAGE
Classify
Payer response is grouped by reason, status, deadline and impacted workflow.
Illustrative operating sequence. Final responsibilities, payer rules and automation scope are confirmed for each engagement.
Organizations served
- Hospitals & Health Systems
- Physician Groups
- Behavioral Health Organizations
- Specialty Practices
INTELLIA relevance
UCG INTELLIA™ supports operational visibility, prioritization and workflow automation across revenue-cycle work, with review roles defined for each process.
- Denial Intelligence: Detect patterns, surface likely root causes, prioritize work and connect recovery findings back to prevention.
- A/R Intelligence: Segment accounts by age, value, payer, denial status and recovery potential.
- Workflow Automation: Trigger worklists, routing, alerts and human-review steps around defined business rules.
Related services
Discuss your workflow with UCG.
Share the revenue-cycle issue, operational priority or payer challenge you are working through.
Get a Denial Analysis