The Challenge
Hospitals across the country are facing rising claim denials, increasing audit activity, and growing administrative burden. The result is delayed payments, lost revenue, and overwhelmed revenue cycle teams.
Healthcare organizations are losing billions due to inefficiencies in denial management:
Over
$0 billion
in claims are denied annually
Over
$0 billion
per year managing appeals
More than
0%
of denied claims are recoverable when appealed
The Wellington Group, LLC helps hospitals take control of their revenue cycle with solutions built specifically for clinical denials, audits, and appeals.
The Solution
The Wellington Group, LLC provides healthcare organizations with powerful, easy-to-use software designed to improve denial management, simplify audits, and accelerate appeals.
Our platform combines proven revenue cycle expertise with AI-driven technology to help hospitals:
Wellington’s software platform helps hospitals reduce manual work, improve visibility, and make better revenue cycle decisions through workflow automation, detailed reporting, and interactive analytics.
WVU Medicine Increased Clinical Appeal Capacity 5X and Defended $16 Million
With more than 25 hospitals, WVU Medicine faced rising denial volumes and increasing payer scrutiny. Clinical specialists often spent more than four hours preparing a single appeal, limiting the number of cases the team could pursue.
WVU Medicine partnered with The Wellington Group to implement AppealNavigator™. By supporting documentation, payer research, and appeal drafting, the solution helped staff generate 10,000 AI-assisted appeal letters within six months while strengthening appeal quality and consistency.
$16 Million
Revenue defended within six months
5X Capacity
Increase in clinical appeal capacity
Under 1 Hour
Average appeal preparation time, down from 4+ hours
72% Success
Reported appeal success rate
“The volume and complexity of clinical denials continue to increase every year. We needed a way to help our team work smarter, not harder.”
— Shari Boyer, Enterprise Director, Denial Management, WVU Medicine
Testimonials
“The volume and complexity of clinical denials continue to increase every year. We needed a way to help our team work smarter, not harder.”
Shari Boyer
Enterprise Director, Denial Management | WVU Medicine
“What impressed us most was how quickly the solution fit into our workflow. AppealNavigator™ gives our team immediate access to the information they need to build stronger appeals while maintaining consistency across our organization.”
Jane Kennedy
Enterprise Director, Utilization Review & Inpatient Appeals | WVU Medicine
“Utilizing AppealNavigator™ has allowed all appeal clinical staff to increase their knowledge, consistency, and effectiveness in writing outstanding appeal letters.”
Lisa Henderson
Enterprise Manager Clinical Appeals and Denials | WVU Medicine
“The volume and complexity of clinical denials continue to increase every year. We needed a way to help our team work smarter, not harder.”
Shari Boyer
Enterprise Director, Denial Management | WVU Medicine
“What impressed us most was how quickly the solution fit into our workflow. AppealNavigator™ gives our team immediate access to the information they need to build stronger appeals while maintaining consistency across our organization.”
Jane Kennedy
Enterprise Director, Utilization Review & Inpatient Appeals | WVU Medicine
“Utilizing AppealNavigator™ has allowed all appeal clinical staff to increase their knowledge, consistency, and effectiveness in writing outstanding appeal letters.”
Lisa Henderson
Enterprise Manager Clinical Appeals and Denials | WVU Medicine
“The volume and complexity of clinical denials continue to increase every year. We needed a way to help our team work smarter, not harder.”
Shari Boyer
Enterprise Director, Denial Management | WVU Medicine
“What impressed us most was how quickly the solution fit into our workflow. AppealNavigator™ gives our team immediate access to the information they need to build stronger appeals while maintaining consistency across our organization.”
Jane Kennedy
Enterprise Director, Utilization Review & Inpatient Appeals | WVU Medicine
“Utilizing AppealNavigator™ has allowed all appeal clinical staff to increase their knowledge, consistency, and effectiveness in writing outstanding appeal letters.”
Lisa Henderson
Enterprise Manager Clinical Appeals and Denials | WVU Medicine
“The volume and complexity of clinical denials continue to increase every year. We needed a way to help our team work smarter, not harder.”
Shari Boyer
Enterprise Director, Denial Management | WVU Medicine
“What impressed us most was how quickly the solution fit into our workflow. AppealNavigator™ gives our team immediate access to the information they need to build stronger appeals while maintaining consistency across our organization.”
Jane Kennedy
Enterprise Director, Utilization Review & Inpatient Appeals | WVU Medicine
“Utilizing AppealNavigator™ has allowed all appeal clinical staff to increase their knowledge, consistency, and effectiveness in writing outstanding appeal letters.”
Lisa Henderson
Enterprise Manager Clinical Appeals and Denials | WVU Medicine