Heron

I write the appeal. You sign it.

Trained on 14,820 of your claims. I score a denial before it happens, draft the letter when it does, and show you which payers and codes cost the most.

Will this one be denied?

Pick a payer and a code, and I update the odds as you go.

Denial rate by payer

Coral is over 25%, sun is over 15%

What the payers cite

The five reasons behind the most open denials

Where denials are piling up

Trends across payer and reason, spotted by me.

UnitedHealthcareMedical Necessity
+18%critical

UnitedHealthcare medical necessity denials increased 18% this quarter. Review clinical documentation standards for this payer.

18 claims affected
AetnaMedical Necessity
+16%critical

Aetna medical necessity denials increased 16% this quarter. Review clinical documentation standards for this payer.

9 claims affected
CignaMedical Necessity
+11%critical

Cigna medical necessity denials increased 11% this quarter. Review clinical documentation standards for this payer.

9 claims affected
BCBSMedical Necessity
+19%critical

BCBS medical necessity denials increased 19% this quarter. Review clinical documentation standards for this payer.

5 claims affected
MedicareMedical Necessity
+14%critical

Medicare medical necessity denials increased 14% this quarter. Review clinical documentation standards for this payer.

5 claims affected

How you compare

Against 127 facilities on the network.

Medicare+9% above average
Top 25%: 3%Average: 5%You: 14%
Attach clinical notes and imaging upfront
Aetna+5% above average
Top 25%: 3%Average: 7%You: 12%
Verify prior auth requirements before submission
Humana+5% above average
Top 25%: 3%Average: 7%You: 12%
Verify prior auth requirements before submission
UnitedHealthcare+4% above average
Top 25%: 4%Average: 7%You: 11%
Verify prior auth requirements before submission