Clinical Denials and Appeals Support Case Study

This case study details the partnership between Sentara Health and Accuity, focusing on clinical revenue support and optimization of revenue capture. Sentara Health, one of the largest not-for-profit integrated health systems in the United States, sought to enhance its revenue cycle management in response to rising costs and complex payer reimbursement challenges. The collaboration began with a proof-of-concept pilot that allowed Sentara to validate financial impacts before committing to a long-term agreement. The results of this partnership included a $34 million annualized net cash benefit and a 4.9% increase in case mix index on charts reviewed by Accuity. The study outlines how Accuity provided detailed reporting, physician education, and implementation support, which facilitated significant improvements in clinical revenue integrity and operational efficiency across Sentara's twelve hospital sites. The case study emphasizes the importance of collaboration between internal teams and Accuity's client success team in achieving these outcomes.