u/Defiant_Image5738

I am validating a no-PHI denial opportunity report format for RCM / billing teams, and I am trying to avoid building something that looks nice but would be useless in a real denial workflow.

The idea is to use only de-identified operational fields, such as:

• payer
• denial reason or CARC/RARC
• denied amount
• date of service or age bucket
• denial date or deadline bucket
• CPT/HCPCS or code category
• current status
• last action taken
• non-PHI notes

The report would try to show:

• payer and denial reason patterns
• high-priority claims by amount and deadline risk
• corrected claim vs appeal vs rebill vs write-off recommendation
• evidence checklist for claims worth pursuing

No patient names, DOB, full member IDs, medical records, clinical notes, or payer portal screenshots.

For people who work denials, AR follow-up, appeals, or billing ops:

1. What fields would be missing before you would trust this?
2. How do you decide corrected claim vs appeal vs write-off today?
3. Would this kind of report help prioritize work, or would it be too generic?
4. What would make the recommendation credible enough for a biller or denial lead to use?

Not asking for PHI or client data. I am looking for workflow critique.