Compliance

Prevent Denials & Reduce Risk

Stop revenue loss before it happens with intelligent denial prevention and comprehensive compliance monitoring.

Up to 40%

Denial reduction

Significant

Loss prevention

Enhanced

Audit readiness

Current Risk Exposure

Typical Denial RateVaries
Potential Compliance GapsMultiple areas
Audit Risk ScoreHigh

Without proactive compliance management:

Significant Annual Risk

Intelligent Denial Prevention

Our AI-powered system catches issues before they become denials

Before Submission
Pre-Bill Review

Catch errors before claims leave your system

Authorization verification
Medical necessity checks
Documentation completeness
Prevention potentialHigh
During Processing
Real-Time Tracking

Monitor claims through the entire lifecycle

Payer response tracking
Automatic appeal triggers
Trend pattern analysis
Recovery potentialStrong
After Resolution
Root Cause Analysis

Learn from every denial to prevent recurrence

Pattern identification
Process improvement
Staff education triggers
Reduction potentialUp to 40%
Always Active
Compliance Shield

Continuous monitoring for regulatory compliance

CMS regulation updates
Payer policy tracking
Audit trail maintenance
Audit preparednessImproved

Comprehensive Risk Coverage

We monitor and protect against all major compliance risks

Regulatory Compliance

  • False Claims Act violations
  • Stark Law & Anti-Kickback
  • HIPAA breaches
  • Medicare conditions

Coding Compliance

  • Upcoding & unbundling
  • DRG manipulation
  • Modifier misuse
  • Medical necessity

Financial Compliance

  • Credit balance violations
  • Timely filing issues
  • Price transparency
  • Charity care policies

Compliance penalties can be

Substantial

Revenue Integrity Lifecycle

Ready for the Next Stage?

With clean billing in place, you're ready for Denials Prevention & Compliance—targeting and limiting revenue loss from denied claims.