Denial Prevention Analytics
The same denial should never happen twice.
Recovery gets the money back. Prevention stops it from leaving. Every month we tell you exactly which upstream mistakes caused your denials, who owns the fix, and whether last month's fix actually worked.
The Problem
The problem: denials are rising, and almost all of them are preventable.
The bitter part of the denial epidemic is that it's mostly self-inflicted — eligibility not checked at scheduling, auths missed, coding edits ignored. Preventable doesn't mean prevented: it takes data nobody in the practice has time to assemble.
What We Do
Deliverables, not promises.
- Monthly root-cause report: top denial reasons, dollar impact, and trend
- Upstream owner assignment — front desk, coding, or authorization — for every recurring cause
- Front-end fix playbooks: eligibility at scheduling, auth workflows, coding edit rules
- Denial-rate trend dashboard — your rate vs. the national benchmark, month over month
- Fix verification: did last month's change actually move the number?
The Difference
How it's different
Prevention reporting is a contractual deliverable of every Claimie engagement, not an upsell. That's deliberately against our own short-term interest: on contingency, we're paid from the denial pipeline we're helping you shrink.
We accept that trade because it's the only honest position — and because practices that trust you with prevention stay for everything else.
What It Costs
Performance pricing or a flat rate. Your choice, your state’s rules.
Model A: a percentage of dollars actually recovered — nothing recovered, nothing owed (most states). Model B: a fixed monthly rate where every recovered dollar is 100% yours (all 50 states). Both start with the free Recovery Audit ($500 value) and its written go/no-go.
See both pricing models →Questions
Asked on every call about denial prevention analytics.
Doesn't prevention cannibalize your own recovery revenue?
Yes — and we say so on the How It Works page. Our stated goal is to shrink our own pipeline. We'd rather compound trust than farm the same preventable denial forever.
Who implements the fixes?
Your team, with our playbooks. We identify the root cause, the owner, and the specific workflow change; you don't need new software to act on it.
Can we buy prevention analytics alone?
It ships as part of every recovery engagement. If you only want analytics, start with the free Recovery Audit — its root-cause analysis is a one-time version of the same work, at no charge.
Know your number before you sign anything.
The Recovery Audit is a $500 analysis — yours free, in writing, with an honest go/no-go. Limited slots each month.
Sources
- 1.As many as 86–90% of denials are preventable. — Kaiser Family Foundation research
- 2.60% of medical groups reported higher denial rates in 2024 vs. 2023. — MGMA 2024 Stat Poll