Denial Drivers — MULTICARE AUBURN MEDICAL CENTER
Current: 0.0% | Recoverable: $0.0M/year
🛡️ Public data only — no PHI permitted on this instance.
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0.0%
Current Denial Rate
8.0%
Target Denial Rate
$0.0M
Recoverable Annual Revenue
5
Root Causes Identified
Denial Root Causes
Decomposition of denial rate into root causes, sized by annual dollar impact.
| Driver | Contribution | Annual Impact | Severity | Magnitude |
|---|---|---|---|---|
| Prior Authorization Denials | 0.0% | $0.0M | high | |
| Coding & Documentation Errors | 0.0% | $0.0M | high | |
| Timely Filing Misses | 0.0% | $0.0M | medium | |
| Medical Necessity Disputes | 0.0% | $0.0M | medium | |
| Eligibility Verification Gaps | 0.0% | $0.0M | medium |
What This Means
At 0.0%, this hospital's denial rate is below average — strong operational performance. Reducing to the target of 8.0% would recover an estimated $0.0M per year in revenue.
Next steps: Request the payer-level denial breakdown in diligence questions. See the full value creation plan in the playbook. Model the EBITDA impact via the EBITDA bridge.
Expert Recommendations
Implement prior auth tracking systemRCM Operations
Automate prior auth status tracking and proactive follow-up
CDI program expansionCoding
Clinical documentation improvement with real-time physician queries
Payer-specific denial protocolsDenial Management
Create playbooks for top denial reasons by payer