Denial Deep Dives
Takebacks, DRG Downgrades, Underpayments, and the Other Losses Denial Reporting Misses
Standard denial reporting counts the losses that look like denials. Takebacks, DRG downgrades, and payer underpayments often post as paid claims or routine adjustments, so they never reach the denial report.
Sift’s deep-dive analysis of remit and payment data across health systems shows where these losses hide and how revenue cycle leaders can surface them.
Download the Deep Dives
Inside the Deep Dives
Each deep dive covers one adverse payment outcome that standard denial reporting misses, including how it works, where it hides in your data, the bigger picture, and next steps your team can act on. Every one ends with a “Run This” query you can take straight to your own data.
What’s Inside:
- Underpayments: inpatient claims paid at observation-level rates with no denial record
- Post-payment takebacks: payer recoupments that land months after you’ve reported the revenue
- DRG downgrades: severity-tier strikes that arrive over years, mostly after payment
- Short-stay denials: level-of-care decisions that never reach the remittance file
- Bundled underpayments: codes that mean both a legitimate adjustment and a shortfall
- Itemized bill denials: under 0.05% of claims, up to 10% of denied dollars
Who It’s For:
- CFOs, CRCOs and VPs of Revenue Cycle who need to see losses that never post as denials
- Revenue integrity and PFS leaders reconciling expected versus actual reimbursement
- CDI and Coding directors tracking DRG downgrades against query yield
- UR and case management teams working level-of-care and short-stay denials
Want to See Your Own Data?
Industry benchmarks are useful, but nothing compares to analyzing your own denial patterns. Request a Denials Insights Report to see where your revenue is at risk—by payer, DRG, and service line.
Aligned to Outcomes, Not Promises
RevProtect is available through a performance-based engagement model designed to align incentives and reduce risk. Sift partners directly with health systems to tie success to measured reductions in denials and adverse payment outcomes (not activity, licenses, or usage).
Talk with us about whether a performance-based model makes sense for your organization.
