1. Find the denial patterns
We start with your own history. AI groups past denials by payer, procedure and reason, and finds the ones that keep coming back. That tells us exactly which checks will pay off first for your practice.
Technology
A touchstone for claims, powered by AI
Clearinghouse scrubbers catch formatting errors. Most denials come from somewhere else: what happened at the front desk and in the chart before the claim existed. Our technology looks there, learns what your payers deny, and stops it before submission.
2. Test every claim before it leaves
Each new claim is compared against that payer's requirements and against the patterns behind past denials. We look at eligibility, credentialing, code-to-chart match and required attachments.
3. Fix it upfront, with a person in the loop
A flagged claim comes with the likely cause and the likely fix. A billing specialist makes the correction, or asks your team to clarify the note, before the claim is released. AI proposes; people decide.
4. Get sharper every week
Every denial, payer response and audit finding goes back into the checks. The longer we work your claims, the fewer surprises there are.
What the gate looks at
The causes behind most denials
Without giving away how our checks work, these are the families of problems they're built to catch:
- Eligibility, frequency limits and waiting periods not confirmed before the visit
- Provider not credentialed or enrolled with the payer
- Codes that don't match what the chart supports
- Missing attachments: X-rays, perio charts, narratives
- Payer-specific rules for the procedure or claim type
- Coordination of benefits and secondary claims
- Claims drifting toward timely-filing limits
Private by design
AI that never leaves the locked room
Our AI runs inside our own HIPAA-eligible cloud environment, covered by business associate agreements. Patient data stays in that environment, with encryption, access controls and logging applied to every request.
- Patient data never leaves our secure environment to train any AI model
- Only the minimum data a check needs is used
- Every request is logged and traceable