Claims Intelligence turns your practice's own claims and ledger history into revenue leverage — payer scorecards, per-code PPO fee analysis, AI-drafted negotiation letters, and a denial-risk check on every claim before it goes out.
Everything below is computed from your practice's real claims, remittances, and ledger — not industry averages.
Denial rates, collection ratios, and the top denial reasons for every payer you bill — computed from your own claims history, so you know exactly which payers cost you the most and why.
Billed vs. allowed for every procedure code, per payer, learned from your remittances and PMS ledger. Codes where a payer allows less than your best contract get flagged automatically.
Letters drafted from your own reimbursement evidence, ready for your review and signature. A built-in tracker follows the whole cycle — draft, sent, countered, accepted — and measures the lift once a new fee takes effect.
No spreadsheets, no consultants, no data entry. Connect once and the analysis builds itself.
Claims Intelligence reads the claims, remittances, and ledger history already sitting in your practice management system.
Payer scorecards and per-code fee benchmarks assemble in the background as claims and payments flow through your practice.
Open the fee analysis and see which codes which payers underpay — with your own dollar amounts as the evidence.
Every number Claims Intelligence shows comes from your practice's own history — your submitted claims, your remittances, your ledger. No industry benchmarks standing in for reality: the amounts cited in a negotiation letter are amounts a payer actually paid, or refused to pay, on your claims.
Claims Intelligence is $149.99/month as an add-on to any plan — and included at no extra cost with the Full PMS and Complete plans.
One successfully renegotiated code typically covers the subscription on its own.
See all pricingFrom your own practice: the claims you've submitted, the remittances payers have sent back, and your PMS ledger. Claims Intelligence doesn't use industry benchmarks or estimates — every denial rate, collection ratio, and allowed amount is computed from your real claims history.
For every payer you bill: denial rate, collection ratio, and the top denial reasons — all computed from your own claims. You see which payers deny most, which pay slowest relative to what they're billed, and exactly which denial reasons keep recurring.
It learns billed vs. allowed amounts per procedure code, per payer, from your remittances and PMS ledger. When a payer's allowed amount on a code sits below your best contract for that same code, it gets flagged as a negotiation candidate — with the dollar evidence attached.
No — the AI drafts each letter from your own reimbursement evidence, and you review it before it goes anywhere. From there, a tracker follows the full cycle: draft, sent, countered, accepted, and the measured lift once a renegotiated fee takes effect.
Every claim is scored before submission, and flagged risks come with the specific fix named: a missing attachment, a frequency limitation, an unmet waiting period, or a prior authorization requirement. The goal is that the problem gets fixed before the payer ever sees the claim.
Every claim is scored before it goes out, and each flagged risk comes with the specific fix named — missing attachment, frequency limit, waiting period, or prior authorization — so it gets corrected before the payer ever sees it.
Generate the negotiation letter from that evidence, send it to the payer, and track the cycle through to an accepted fee.
$149.99/month as an add-on to any plan. It's included at no extra cost with the Full PMS and Complete plans. Many practices find that one successfully renegotiated code covers the subscription — though results depend on your payers and contracts.
Connect your PMS and let your own claims history show you which payers underpay — and what to do about it.
