Turning Denial Data into Actionable Insights for Hospitals

Thursday, January 29th, 2026

1:00pm-2:00pm EST

As post-payment audits by Medicare Advantage and commercial payers increase, hospitals are identifying performance improvement opportunities due to systemic breakdowns in utilization review, admission status determinations, and failure to act on denial trends. This session demonstrates how structured analysis of overturned and upheld denials can reveal hidden operational vulnerabilities—and how hospitals can turn those insights into scalable interventions. Real-world case examples and a data dashboard from a multi-hospital system will show how denial data can guide improvements in gatekeeping, physician documentation, the two-midnight rule, inter-facility transfer protocols, and more. Attendees will receive tools to start a denial analytics workflow and use it to drive care management policy, physician re-education, and payer accountability

By the end of this webinar, attendee will be able to:

1. Identify systemic breakdowns in case management and utilization review workflows using post-payment audit and denial data.
2. Analyze denial root causes to guide targeted interventions, including physician re-education and improved admission decision-making.
3. Develop internal escalation, payer engagement, and audit-response strategies to reduce revenue loss and enhance compliance.
4. Apply denial analytics to strengthen interdepartmental collaboration and improve accountability across clinical, revenue cycle, and compliance teams