Denials 360 gives RCM teams AI-powered triage, root cause analytics, underpayment recovery, and payer-ready appeals — all in one HIPAA-compliant platform.
Payers use AI to deny faster. Your team is still working from aging reports and multiple disconnected systems. Every hour spent on manual research is an hour not spent recovering revenue.
Real-time dashboards surface denial trends by payer, CPT/HCPCS code, ICD-10 diagnosis, facility, and CO/PR reason code — giving your leadership live insight into root causes, not just volume.
The Prior Auth RCM Agent assesses every prior authorization denial, identifies the root cause, and delivers a precise AI-recommended action plan — so your analysts spend their time executing, not investigating. What used to take 45 minutes now takes under 5.
RCM teams lose hours every day context-switching between systems. Denials 360 is a single, purpose-built denial management workspace — from open to close, without leaving the platform.
Denials 360 generates payer-ready appeal letters using the denial reason code, claim details, authorization history, and clinical context already in the system — with payer-specific formatting applied automatically.
We help RCM teams recover revenue from claims that never received a payer response. By processing 277 status files, we surface stuck claims before they age into write offs.
We process 277 files to identify the claim status, flagging claims that are rejected or pending payer review.
We configure tracking windows for every carrier and plan type. Claims exceeding turnaround time surface automatically.
Sort queues by claim value, aging, or payer. Your team works the highest impact claims first, not random aging reports.
Managers see total outstanding revenue across every queue in real time. No more end of month surprises about AR at risk.
Every status update, payer response, and action is logged. Compliance is covered and team performance is measurable.
Act on 277 data instead of waiting weeks for 835s. Reduce days in AR and recover revenue before claims age out.
Denials get all the attention. Underpayments don't. Denials 360 uses machine learning to detect underpaid claims by comparing actual payer reimbursements against historical payer payment patterns — surfacing recovery opportunities that contract-based variance checks miss entirely.
Real-time visibility into analyst productivity, denial resolution rates, appeal outcomes, and timely filing compliance — so you can manage the team, not just the claims.
Denials 360 speaks your language — prior auth, retro authorization, field locator 63, CO and PR denial codes, timely filing. Your team productive on day one.