Denials worked. Revenue recovered.
How it works
Reads the denial
Works through the remittances and electronic remits, reads each denial code, and figures out why the claim denied and whether it's recoverable.
Corrects & resubmits
Maps the denial code to the fix - a missing modifier, an eligibility error, a coding issue - repairs the claim, and resubmits it clean.
Appeals & escalates
For denials that need to be argued, it assembles the appeal packet with the supporting records and routes it to staff to review and sign off.
From denial to resubmitted, end to end
It reads the denial on the remittance, maps the code to the correct fix, repairs the claim, and resubmits it clean - or assembles the appeal packet when the claim needs to be argued.
Works in the tools you already use
Waystar
Change Healthcare
Availity
Epic
athenahealth
SlackFrequently asked
Collections is about calling on overdue balances. This is claim-level payer rework: it reads payer denial codes on the remittance, corrects and resubmits the claims that can be fixed, and assembles appeals for the rest. Different work, different system - the denial queue inside your clearinghouse, not the phone.
The high-volume, rules-based ones: missing or incorrect modifiers, eligibility and registration errors, coordination-of-benefits issues, timely-filing, and coding mismatches. It corrects and resubmits those, and routes anything that needs clinical or human judgment to staff.
No. It assembles the appeal packet - the claim, the denial, and the supporting records - and routes it to your billers to review and approve. A person signs off before an appeal goes to the payer.
Your clearinghouse and EHR - Waystar, Change Healthcare, Availity, Epic, athenahealth - working the denial queue the way an RCM specialist would, scoped to your compliance requirements.
Your first AI employee
is one call away
Caesar will call you right now, introduce himself, and show you exactly how this works.