!Denial workflow

Denial management

DenialOS organizes denial recovery around a controlled case lifecycle.

Core operating surfaces

• intake and extraction
• case queue
• deadline awareness
• evidence review
• appeal preparation
• human approval
• payer interaction records
• rework and escalation
• outcome recording
• operational analytics.

The codebase also contains specialized domains for appeals, evidence, action selection, intervention execution, case recovery, payer interactions, and outcome evaluation.

Denial truth

A denial should be grounded in an observed source. For EHR ingestion, an explicit denial/adjudication signal is required before an EHR Claim can enter the denial-processing path.

Missing reimbursement information is not itself treated as a denial fact.