04Charge accuracy
Charge accuracy, and the money left on the table.
Every claim checked for what actually gets claims denied, priced against your contracts — and watched after it pays.
UnitedHealthcareAetnaCignaState Medicaid
Provider taxonomy
2084P0800XService facilityClinic A
NPI 1043…CPT / modifier
90868 mod 95Coding rulesNCCI add-on ✓
Fee schedule
| CPT | Mod | Allowed |
|---|---|---|
90867 | — | $300.00 |
90868 | 95 | $175.00 |
99214 | 95 | $200.00 |
Pre-submission scrubbing
Caught before the payer can deny it
Three failure classes are checked on every claim before it leaves — with the fix attached, not just a flag.
Missing. Required data that isn't there — a member ID, a rendering NPI, an auth number.
Contradictory. A code the chart note doesn't support, or one that could be more specific.
Payer policy. The evidence that payer wants for that code — like proof of prior failed therapies.
Denial-proofing
Underpayments
It flags what's paid below contract
Usually nothing watches for a claim paid under your contracted rate. We compare every payment to the expected amount and route the gap to recovery — detection and the follow-up, not just a report.
Below contract
Coding rules
The rules that keep charges correct
The fields your EHR stores but never lets you act on per claim — held here as rules and written to every submission.
Taxonomy. Per-payer provider taxonomy, auto-refreshed from the CMS source.
Fees & modifiers. Custom CPT, modifier, and modifier-based pricing per payer.
Coding rules. Add-on and clinical-status rules applied per encounter.