Revenue Protection Vertical

Stop RevenueLeakage

Turn claims, clinical, and contract data into a single revenue command center. Detect denials early, recover underpayments, and prove clinical validity at scale.

-32%

denial rate

Denial Prevention

Identify denial drivers by payer, service line, and clinical context with realtime alerts.

+$2.4M

recovered

Underpayment Detection

Compare contracted rates vs remits to surface variance and recover leakage.

98%

audit ready

Clinical-Claims Reconciliation

Validate coded services with clinical evidence to reduce audit risk.

Executive KPIs

Track the metrics that drive margin and payer performance with auditable evidence.

-27%

Denial Rate

Reduce 15-30%

+3.2%

Underpayment Recovery

+2-5% net revenue

+24%

Appeal Win Rate

Increase 20%+

-8 days

Days in AR

Shorten 5-10 days

Who It's For

Built for payer and provider teams who own revenue performance and audit readiness.

Revenue Cycle

Denials, underpayments, and payer variance visibility.

Compliance & Audit

Evidence-ready trails tied to clinical and contract data.

Clinical Operations

Charge capture and documentation quality insights.

Data Foundation

Revenue Protection blends payer and provider signals into a unified semantic layer. Every metric is traceable to clinical evidence, contracts, and remittance detail.

Claims & EOBs
Eligibility & Enrollment
Provider Contracts
Clinical Encounters
Payments & Remittances
Authorization & Referrals

Enterprise Controls

  • PHI-safe analytics with HIPAA Safe Harbor enforcement.
  • Contract-aware measures with audit-ready lineage.
  • Role-based access aligned to finance, ops, and clinical teams.
  • Prebuilt playbooks for denials, underpayments, and charge capture.

Core Capabilities

Focused capabilities aligned to revenue risk reduction and recovery.

Claims + Clinical Reconciliation

Tie coded services to clinical evidence for audit-ready reporting.

Variance Monitoring

Surface payer contract variance with traceable inputs.

Workflow Alerts

Operational alerts with thresholds and prioritization.

Executive Reporting

KPI dashboards for margin, denials, and recovery.

Visual Snapshot

What revenue leaders see on day one: prioritized risk, recovery, and action queues.

Revenue Protection Dashboard
LiveLast updated: Just now
Denial Hotspots
Top 5
Prior Auth Issues
90%
Medical Necessity
75%
Timely Filing
60%
Duplicate Claims
45%
Coding Errors
30%
Variance Recovery
+$2.4M
MonSun
Appeals Queue
By ROI

Cardiology - Aetna

$45K potential

Critical

Oncology - BCBS

$32K potential

High

Ortho - United

$28K potential

High

Operational Playbooks

Proven workflows to move from insight to action without additional tooling.

High-denial service lines with root-cause attribution
High
Charge capture optimization with CDI gaps
Medium
Contract variance monitoring by payer and facility
High
Appeals prioritization by recovery impact
Critical

Why Revenue Teams Buy

Reduce financial risk, unlock measurable recovery, and gain operational certainty.

Risk Reduction

Evidence-backed denials prevention with audit-ready lineage.

Guaranteed ROI

Clear recovery impact tied to underpayment and contract variance.

Operational Certainty

Automated alerts and playbooks reduce manual effort and delays.

Protect Every Dollar of Revenue

Launch in weeks with governed metrics, ready-to-run dashboards, and automated alerts.

Data Pods
Semantic Layer
Dashboards
Request Revenue Protection Demo