Case Study: Legacy Health improves utilization review and reduces denials with Xsolis

Legacy Health reduces downgrades by 75% with XSOLIS

Legacy Health faced a challenge in gauging the true effectiveness of its utilization review process. The hospital system struggled with a heightened denial rate and lacked visibility into the final outcomes of its status determinations, making it difficult to connect retrospective data to concurrent processes. To address this, Legacy Health partnered with vendor XSOLIS for a new approach.

XSOLIS implemented its Dragonfly platform to re-engineer Legacy Health's utilization review with a data-driven foundation. The solution provided an end-to-end view of each case, diverted attention to high-risk patients, and ensured consistent level of care determinations. This multi-pronged approach, which also included leveraging XSOLIS's Denials Services team, had profound financial implications. Inaccurate staff decisions were reduced by 75%, appropriate conversions increased by over 43%, and the initiative resulted in an eight-figure positive financial impact for Legacy Health.

Legacy Health