Predictive Denial Blocker (PDB) — 1,000+ rules, including your own denial history
Your clearinghouse catches the obvious stuff. Ours catches the stuff that actually causes denials.
The short version
Your clearinghouse catches the obvious stuff — missing fields, invalid codes, basic edits. Ours catches the stuff that actually causes denials.
The Predictive Denial Blocker (PDB) runs every claim through 1,000+ rules that go well beyond standard edits. It checks against CCI bundles, LCD/NCD policies, payer-specific quirks (and every payer has quirks), and — here's the real edge — patterns from your own denial history. If Cigna denied a specific procedure-diagnosis combination three times last month, PDB flags that combination before it goes out the door again.
It doesn't just say "error." It says "here's the error, here's why, and here's the fix." One click to apply the correction. That's it.
Features that actually move the needle
1,000+ rules out of the box
CCI bundles, LCD/NCD policies, modifier validity, frequency limits, medical-necessity edits, and payer-specific quirks for every major payer.
Learns from your denial history
Your past denials become future rules. If a payer rejected a specific procedure-diagnosis combination three times, PDB flags it before claim four goes out.
Fix-it suggestions, not just flags
Every issue comes with the why and the fix. One-click corrections turn a 20-minute investigation into a 30-second action.
Sustained clean-claim rate above 97%
Fewer rejections, faster payment, materially less rework — and the lift compounds as the model learns your data.
Any provider running enough volume that even a 2% denial rate is hurting the bottom line.
The rest of the product suite
Tired of watching revenue leak out the back door?
Let us audit your revenue cycle. Free. No strings.