Claims & Denials Agent
Denials worked before they age out. The Claims & Denials Agent reads your remittances, sorts every denial by reason and deadline, finds what was missing, and has the corrected claim or appeal drafted for your biller.
The problem
Denied claims pile up because working them is slow: read the remittance code, pull the chart, find the missing modifier or authorization, write the appeal. Every payer has its own filing window, and a denial that sits too long becomes a write-off.
How it works
- Reads remittancesPulls ERA (835) files and denial reports from your clearinghouse every day.
- Sorts denialsGroups them by reason code and payer, and puts the ones closest to their filing deadline first.
- Finds the missing pieceChecks each claim against its denial reason: eligibility, authorization, coding, modifiers or missing documentation.
- Drafts the fixA corrected claim or an appeal letter, with the supporting documents listed, ready for your biller.
- Your biller submits needs approvalNothing is resubmitted or sent to a payer until your biller reviews it and submits it.
- Read remittances and denial reports
- Sort denials by reason, payer and deadline
- Draft corrected claims and appeal letters
- Keep a log of every denial and its status
- Submit claims or appeals on its own
- Change codes or notes in your EHR
- Contact patients or payers
- Write off a balance
Book a demo
Tell us a little about your office. We reply within one business day to set up a 20-minute demo of the Claims & Denials Agent. Prefer to talk now? Call 719-451-1218.
Thanks, that is on its way.
We will email you within one business day to set a demo time. An automated first estimate may arrive by email before that; the prices on this page are what we quote. If it is urgent, call 719-451-1218.