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We use computer intelligence to automate claim management process and make it readily available as cloud service with zero configuration.  Using AI augmentation improves human productivity and helps avoid or recover 30-60% denials that could not be recovered before 

Computer Intelligence for Managing Medical Claim Denials

PINNACLE SERVICES CORPORATION

Getting paid by insurance companies is a major problem for medical service providers. With constantly changing insurance payment policies and Medicare rules, service providers can lose 20% - 50% of revenue due to medical claim denials.

Most of these denials can be recovered and avoided if the denial is predicted at the time of order. Our predictive analytics and Computer Intelligence platform helps predict and avoid claim denials, collect more payments and reduce the cost of billing for medical service providers of any size.

 

LEARN

Our PayPredict Learning Engine is meticulously sifting through historical data exchanged between the provider and  payers and learns every detail about:

  • Insurance  payment and denial rules

  • Reimbursement rates and Expect Fees

  • Claim refiling success rate

  • Timely Filing Limits

  • Order volume trends

APPLY

Our Web Applications use the knowledge to boost the productivity of denial management process and help humans to:  

  • Focus claim follow-up process on high-value denials that are easy to fix

  • Stay within Timely Filing Limits

  • Track outstanding claims 

  • Alert about reimbursement trend changes

  • Fix many problems automatically before sending the claim

GET AHEAD

Get productivity boost and net revenue gains that go straight to the bottom line.  Happier billing team that does not feel overworked and understaffed. Ability to focus on serving your patients rather than worrying about being paid.​​

You have nothing to lose, literally - evaluation is easy and free