Denials and Insurance Followup

Up to 65% of denied claims are never reworked, which means millions in recoverable revenue are left behind.

The Real Cost of Denials

For hospitals and health systems, denials create unpredictable revenue, bloated admin costs, and staff burnout. They also point to deeper issues, like gaps in clinical documentation, pre-auth processes, or eligibility checks.

We don’t just fix denials, we prevent them with root cause analytics, CDI insights, and automation tailored to your trends.

Increased Recovery and Efficiency Using AI and Machine Learning

The average cost to manually work a claim is $43.84. Our proprietary technology platform allows us to identify claims that are promised to pay, allowing us to focus on only the denied or underpaid claims that need to be worked. Claims not found at the payer are immediately resubmitted to prevent any timely filing denials.  AI-driven work queues then present the representative with the most probable claim to collect based on denial information from the payer, compared against millions of previous claim outcomes. A typical scenario is over 100% more efficient than historic manual claims efforts, thus necessitating fewer personnel per project.