DenialXM is a five-skill Workato Genie for healthcare revenue cycle (RCM) teams. An RCM user supplies four values once — payer, provider NPI, date range and claim status — and the Genie does the rest: 

Skill 01 resolves the payer name to the payer ID every downstream call depends on; 

Skill 02 sweeps claim status against the Optum claim status API and filters to denied; 

Skill 03 pulls the full denial payload (CARC, RARC, adjusted amount, appeal eligibility) machine-to-machine;

Skill 04 classifies the denial, scores recoverability and writes a rationale; and 

Skill 05 assigns a team, a queue and a next workflow (for example draft_appeal_packet). Deterministic handoffs make every skill testable in isolation, and guardrails route low-confidence, unknown-code and incomplete-payload claims to human review rather than guessing. 

Target users are denial analysts, AR supervisors and RCM operations leaders at provider organisations and billing companies. Supported integrations: Optum Medical Network APIs (payerlist v1, claimstatus v2, reports v2); routing and classification rules are client-configurable without code changes.