Protect — Claims management
Catch the denial before the payer does.
Everything in the Integration hub, plus the full claim lifecycle — from bulk intake through three stages of AI scrubbing, denial management, and AI-powered appeal generation.
3
Scrubbing stages
Schema, rules, then AI
20+
Rule patterns
Applied per claim
AI
Appeal drafts
3-step wizard
0
Missed deadlines
Filing deadline tracking
The clean-claim sequence
Every claim runs through three stages before it reaches a payer. Each stage catches what the previous one can't.
Schema validation
Structural checks — required fields present, formats correct, relationships valid. Instant, deterministic.
Rules engine
20+ clinical and billing rules applied. Bundling conflicts, modifier requirements, timely filing — caught before submission.
AI review
Machine learning reviews what rules can’t. Documentation gaps, coding specificity, payer-specific denial patterns. Confidence scores on every flag.
Searchable ICD-10 coding
Type E11 and search the entire ICD-10 database live. No code books, no memorizing. Controlled values for payer and place of service.
Claim Assist
AI validates codes against payer rules, flags documentation gaps, and catches bundling issues. A second opinion on every claim, in seconds.
Denial risk scoring
Every claim gets a denial probability once payer and diagnoses are set. See risky claims before they ship.
AI appeal generation
Three-step wizard: AI drafts the appeal citing clinical evidence, you edit, then submit. Appeal levels match your market.
Smart work queue
Prioritized by financial impact, filing deadline, and appeal success probability. Your team always works the highest-value item.
Bulk intake
Drop an 837 file or CSV of a day’s encounters. The system parses and creates draft claims automatically. One action, one day’s work loaded.