AI can do more for your business. We’ll show you where.
We talk through your priorities, analyze your systems and data, and come back with a plan sized to your own numbers.
From AI ambitions to a plan you can act on.
Most companies see what AI is doing for others and want the same. The hard part is knowing where to start, and how AI connects to the goals you already have. Too often, projects get picked on anecdotes and vendor pitches.
AI Value Mapping starts with your priorities. We measure where you are today, model what’s realistic from your own data, and size the return, so leadership decides on evidence.
Clear value propositions for data-driven decisions.
Each major initiative gets a full project design like this sample: the problem today, what it costs, what we would build, and the expected return.
Claim Review and Denial Recovery
The billing services team works every denied claim by hand. A biller opens the denial, looks up the reason code, finds the chart, and decides whether to correct, appeal, or write it off, with no shared view of which denials are worth the most or which errors keep coming back. Claim Review and Denial Recovery checks every claim against payer rules before it goes out, sorts each morning’s denials by recoverable value and deadline, and drafts the correction or appeal for a biller to approve. It starts with the three payers behind 61% of denials.
- Pays for itself in about 9 months, including the build.
- About $216,000 a year in value once live, from fewer denials, faster work, and more recovered charges.
- About 3.7x return on cost over five years.
- About $1.6 million of added enterprise value.
Denials are worked in the order they arrive. Billers spend most of each denial finding the reason and the documentation, not fixing the claim, and 38% of denials come from eligibility, modifier, and registration errors that could be caught before submission. Denials that wait too long pass the payer’s appeal deadline: 11% of denied charges last year were written off that way.
| What it costs today | Today | Source |
|---|---|---|
| Claims submitted for billing clients | 486,000 a year | PM system · T12M |
| Denied claims | 46,656 a year (9.6%) | Clearinghouse 835s · T12M |
| Denied charges | $6,438,528 a year | Clearinghouse 835s · T12M |
| Denied charges recovered | 57% | Billing ledger · T12M |
| Biller time per denial | 34 minutes | Time study · 4 billers, 2 wks |
| Loaded biller cost | $31.80 an hour | Payroll · loaded |
| Billing services fee | 7.0% of collections | Client MSAs |
Baseline metrics provided by the business. T12M: trailing twelve months.
| Improvement | Conservative | Expected | Best | Expected value |
|---|---|---|---|---|
| Denials prevented38% of denials came from errors a rule check can catch before submission. The expected case prevents about one in four of those. | 6% | 10% | 15% | $84,074 |
| Biller time per denial41% of each denial’s time went to finding the reason and the documentation. Triage and drafting remove part of that. | 9% | 15% | 22% | $113,500 |
| Denied charges recovered11% of denied charges passed the appeal deadline unworked. Working by value and deadline recovers part of them, at the 7.0% fee. | +2 pts | +4 pts | +6 pts | $18,028 |
| Conservative, expected, and best case | Conservative | Expected | Best |
|---|---|---|---|
| Annual benefit at full run rate | $130,585 | $215,602 | $310,372 |
| Payback from kickoff | 13.9 months | 9.0 months | 7.2 months |
| 5-year return on cost | 2.2x | 3.7x | 5.3x |
Baseline. Provided by the business: twelve months of practice management and clearinghouse remittance data, a two-week time study with four billers, and loaded cost from payroll.
Projections. Set from two lookbacks on the same twelve months. The reason-code lookback grouped all 46,656 denials: 38% were eligibility, modifier, or registration errors catchable before submission, and three payers accounted for 61%. The deadline lookback found a median of 19 days before a biller first touched a denial, and 11% of denied charges passed the appeal window. The expected case sits below what each lookback supports, and the conservative case well below.
To confirm in discovery. Appeal windows for the top payers, access to chart notes from each EHR the practices use, and biller capacity during the pilot.
Claim Review and Denial Recovery was one of twelve initiatives identified across the business. The full list is below, grouped by priority and ranked by return.
| Initiative | Department | Annual benefit | 5-yr return |
|---|---|---|---|
| Initial priorities | |||
| Claim Review and Denial Recovery | Revenue cycle | $215,602 | 3.7x |
| Prior authorization assistant | Revenue cycle | $88,250 | 2.1x |
| Support ticket triage | Customer support | $61,700 | 1.8x |
| Phase two | |||
| Practice onboarding assistant | Implementation | $44,900 | 1.4x |
| Patient payment reminders | Patient billing | $38,200 | 1.3x |
| Below the line | |||
| Eligibility checks at scheduling | Front office | $16,300 | 0.9x |
| Practice churn signals | Customer success | $21,400 | 0.8x |
| Coding review assist | Revenue cycle | $18,600 | 0.7x |
| Payer contract variance | Finance | $14,700 | 0.7x |
| Renewal preparation | Finance | $12,900 | 0.6x |
| Visit note summaries | Clinical operations | $9,800 | 0.4x |
| Proposal drafting for new practices | Sales | $7,600 | 0.3x |
Below the line: projected return under 1.0x over five years at current volumes. These are revisited as volumes or costs change.
Every line item in the build, from discovery through launch.
| Line item | Description |
|---|---|
| Discovery | Working sessions with billers, billing managers, and coders. The denial rules that live in people’s heads, written down as user stories. |
| Schema design | One reviewed schema for claims, remittances, reason codes, payers, practices, appeal deadlines, and outcomes, mapped to the practice management system and clearinghouse. |
| Solution architecture | Clearinghouse claim and remittance feeds, practice management sync with narrow write-back, the claim-check approach, and practice-level security and environments. |
| Application provisioning | The billing team’s denial workspace, assembled around the approved schema, with admin console and feedback loop. |
| Roles and permissions | Biller, billing manager, coder, and admin access levels. |
| Single sign-on setup | Sign-in with existing work accounts. Access ends as soon as IT disables an account. |
| Team-based record access | Billers see their assigned practices by default, with cross-practice views for leadership. |
| Complex page | Denial work queue ranked by recoverable value and deadline, and a claim view with the reason, chart notes, and draft side by side. |
| Pre-submission rules engine | Payer rules and the company’s own denial history checked on every claim before it goes out, with a reason for each flag. |
| Integration: clearinghouse | Claims out, remittances and reason codes in, and appeal status tracked. |
| Integration: practice management | Claims, encounters, and payers read. Corrections written back after a biller approves them. |
| Integration: EHR documents | Chart notes and attachments pulled for appeals, within each user’s access. |
| Data migration | Twelve months of denials, outcomes, and payer rules reshaped and loaded before go-live. |
| Notifications and alerts | Flags for appeal deadlines at risk, denial spikes by payer, and high-value claims stuck in the queue. |
| AI assistant | Answers denial questions within each user’s access, such as why a payer keeps rejecting a code. |
| Custom prompt engineering | Correction and appeal drafting tuned to each top payer, with biller feedback turned into standing rules. |
| Train the trainer | One session preparing billing leads to train their teams. |
| Project management | Weekly working sessions, pilot coordination with the top three payers, and system access with the billing team. |
| Foundation Professional | The application on Olytic Foundation: single sign-on, API access, the rules engine, connections maintained by Olytic, HIPAA-compliant hosting under a business associate agreement, and AI credits. |
How we work together
Discovery
We talk with three or four of your leaders about priorities and where work gets stuck.
Analysis
We connect to your systems and pull the baseline numbers behind each priority.
Modeling
We project realistic improvement from your data, then model benefit and payback.
Recommendations
We walk your leadership through the top opportunities, each with a business case.
What you get
The Readout
Everything we uncover, organized in one place, with the effort and benefit of each.
The Roadmap
The work worth doing first, sequenced into a program for the months ahead that accounts for dependencies.
The Project Designs
A full business case, scope, and risks for each major initiative, plus shorter write-ups for quick wins.
Where AI Value Mapping fits
AI Value Mapping is for leaders who make data-driven investment decisions.
It is the right fit when:
- You know AI could do more for your business, but not where it fits.
- You want AI investments that materially improve margin and enterprise value.
- You would rather decide from your own numbers than from a vendor’s pitch.
- You need a business case your leadership, investors, or board can stand behind.
Data access, security, and client responsibilities
How we access and protect your data, and what the engagement requires from your team.
What we access
Olytic requires read access to the client’s core systems of record, typically accounting, ERP, and CRM, for the duration of the engagement. Access is granted through a dedicated credential issued and controlled by the client’s IT team, and may be revoked by the client at any time.
Access is limited to the project team assigned to the engagement, on a need-to-know basis, and to the data the analysis requires. Client data is not shared with any person outside that team.
How it’s protected
A mutual confidentiality agreement and a data protection agreement are executed before any credential is issued.
Client data is processed only through enterprise AI services that do not train on it, which minimizes the risk of data leakage. Client data is never entered into consumer AI tools.
On delivery, the client revokes Olytic’s credentials. Working data is returned or deleted in accordance with the data protection agreement.
What we need from you
The client provides system access before kickoff, a named contact able to produce reports promptly, and a discovery meeting with each of three to four key stakeholders.
The client provides current, measured figures from financial reports or systems of record for the metrics each opportunity would affect, for example annual overtime spend, annual fuel spend, or average sales cycle length. Estimates may inform the search for opportunities but do not support a business case.
Where a baseline cannot be measured or shared, Olytic cannot model a gain for the affected opportunity. Olytic confirms data availability before the engagement begins and identifies any opportunity a missing figure would affect.
Let’s talk through your priorities.
Tell us what you want to get done, and we’ll show you where AI can help.