Reduce denials, detect payer rule changes and increase revenues through proactive claim intervention
Our AI driven solution enhances healthcare efficiency by optimizing revenue, minimizing errors, and streamlining workflows.
How Does Claim Denial Prediction Work?
Claim Denial Prediction leverages your claims data within the platform to proactively identify propensity or chances of claim denial based on several parameters such as service code, diagnosis code, payer name, modifiers prior to claim submission. This tool allows your teams to take corrective action leading to a reduction in denials and increased revenues.
- Real-time individual claim evaluation to identify preventable denials prior to claim submission.
- Historic payment data tuned to your organization’s denial trends leveraged for continuous learning and adaptation
- Freedom to customize and adjust denial risk thresholds over time
- Analytical and operational reports that track product impact and ROI
- Targeted insights on the health of the total claim evaluation process
What This Means for Your Practice ?
Given the impact denials have on your bottom line, it’s critical to ensure that teams have the right tool to mitigate the risk of preventable denials. Claim Denial Prediction leverages your claims data within the platform to proactively identify claims with high likelihood of denial, based on undocumented payer adjudication practices, prior to claim submission. This tool allows your teams to take corrective action leading to a reduction in denials and increased revenues.
Predictive Denials flags claims that have a high potential of denial so the right specialist can intervene before claims go to payers. This allows you to avoid lengthy and costly triage and appeals processes.
How Neurex AI Can Help
Denial Rate
% of claims denied by payers.
First Pass Acceptance Rate
% of claims paid on first submission.
Top Denial Reasons
Common reasons by volume and value.
Denial Recovery Rate
% of denied claims successfully recovered.
Time to Resolve Denials
Average days to resolve denied claims.
Denials by Payer
Denial rate per insurance payer.
Claim Appeal Success Rate
% of successful appeals.
Denial Categories Analysis
Trends by categories (e.g., coding, eligibility).
Write-Off Rate for Denied Claims
% of claims written off.
Eligibility Verification Rate
% claims verified for eligibility.
Timely Filing Compliance
% of claims submitted on time.
Stop Denials at early stage
This ensures your claims move smoothly through the revenue cycle.
Why Choose Neurex AI?
At Neurex AI, we don’t just give you tools—we become your partner in managing your revenue cycle. Our advanced AI, seamless integration, and actionable insights make it easier to deliver accurate, efficient, and compliant billing processes. Let us handle the complexities of your mid-revenue cycle so you can focus on what you do best: caring for your patients.
CLAIM DENIAL PREDICTION APP
This app is fully integrated within your Snowflake environment, meaning your data remains within your own Snowflake account—eliminating the need for external data transfers while maintaining security and compliance.
How it works?
- Request Access
- Approval Process
- App Deployment
- Account Setup
- Data Activation
- Visualization & Insights
Let’s work together to simplify your revenue cycle.
Contact us today to see how Neurex AI can make a difference in your practice.