Complex Denials Suite

Overturn and prevent denials

EnableComp handles all denial categories with specialized focus on the most challenging clinical denials. We combine decades-deep experience and AI-driven technology to accelerate denial resolution, prevent future write-offs, and recover more revenue.

Intelligent Technology

Intelligent tech for denial prevention and management

Denials are soaring as payers accelerate their use of AI-driven tech to automatically reject claims. You need the right partner to give you a strong line of defense.
EnableComp’s e360 RCM® platform brings unmatched Complex Revenue Intelligence™ to denial prevention and management. Rules-based automation and insights from previous payer denials reduce rework, shorten appeal cycles, and eliminate preventable denials from the outset.
Built-in reimbursement modeling and robust analytics expose denial trends, while AI-driven adaptive learning strengthens the platform with every denial appealed.
Paired with oversight from our team of denials experts, e360 transforms denial management from a costly, reactive process into a proactive strategy for protecting hospital revenue.

Learn More

Intelligent tech for denial prevention and resolution

EnableComp’s e360 RCM® platform brings unmatched Complex Revenue Intelligence™ to denial prevention and management. Rules-based automation and insights from previous payer denials reduce rework, shorten appeal cycles, and eliminate preventable denials from the outset.

Built-in reimbursement modeling and robust analytics expose denial trends, while AI-driven adaptive learning strengthens the platform with every denial appealed.

Paired with oversight from our team of denials experts, e360 transforms denial management from a costly, reactive process into a proactive strategy for protecting hospital revenue.

Complex Denials Suite

ED Downgrades

When ED visits are downgraded, hospitals lose revenue. EnableComp reviews records and builds appeals that defend higher-level care and return correct reimbursement.

  • Prevent ED underpayments
  • Substantiate level of service
  • Boost appeal wins
  • Safeguard ED revenue

DRG Downgrades

When DRGs are downgraded inaccurately, hospitals lose rightful payment. EnableComp reviews records and creates strong appeals to defend accurate coding and recover revenue.

  • Protect revenue for delivered care
  • Resolve DRG downgrade appeals faster
  • Improve cash flow

Medical Necessity Denials

When claims are denied for medical necessity, reimbursement suffers. EnableComp reviews records, assembles required documentation, builds targeted appeals, and helps hospitals recover the revenue they’re due.

  • Defend clinical judgment
  • Align documentation
  • Improve appeal wins
  • Reduce future medical necessity denials

Coordination of Benefits (COB) Denials

When payer disputes over who should pay the bill stalls claims, reimbursement lingers in limbo. EnableComp clears COB denials by verifying coverage, resolving conflicts, and restoring payment flow.

  • Resolve COB disputes faster
  • Break the cycle of payer runarounds
  • Reduce AR days
  • Recover full revenue due

Complex Revenue Intelligence™: The smarter way to manage denials

Complex Revenue Intelligence (CRI) is the strategic advantage behind our Complex Denials Suite. Powered by EnableComp’s e360 platform and decades of expertise, we help providers shift from scrambling to address denials to reducing and preventing denials that can be averted outright.

CRI not only recovers lost dollars, it helps avoid write-offs and eases administrative burden. Hospitals gain clearer visibility into denial patterns and actionable foresight for smarter decision-making.

The result? Fewer surprises, less friction, and revenue recovered that would otherwise be lost.

Real outcomes. Proven impact.

$50M+

Recovered from clinical denials in last year alone

25+

Years denials management expertise

50

Denial coverage across all states

Our clients say it best

"Having this partnership [with Enablecomp] in place and those early returns has really allowed us to redirect our efforts and figure out where we can make strategic investments as a result of those [financial] successes."
Sarah Ginnetti, UConn Health, AVP, Revenue Cycle
"As a leader in specialty claims, our partnership with EnableComp continues to be a valuable asset to Northwestern Medicine."
John A. Orsini, Northwestern Medicine, EVP and CFO
"Choosing EnableComp was an easy decision for our hospital. They have maximized our workers' comp claim revenue and have allowed us to reallocate trained team members to other areas of our RCM department."
Judy Briggs, Regional One Health, Vice President, Revenue Cycle
"Their expertise and in-depth knowledge of Medicaid regulations across all states ensure accurate and timely billing and payment of our claims, resulting in improved cash flow to the institution. As a result of their reasonable and competitive fees, the increased cash flow is realized at a cost which is lower than if our in-house staff handled the claims."
Juan Seijido, Memorial Sloan-Kettering Cancer Center, Director, Patient Accounts

Connect with us to unlock hidden revenue

Learn how our e360 RCM® platform, decades of data-driven insight and specialized expertise help hospitals recover more revenue, faster.