Healthcare

Revenue cycle
with clinical integrity

Payer mix, denial recovery, and HIPAA-aligned financial controls for providers who cannot compromise on compliance.

Payer mix

Medicare

Avg $142 · 28 days

Medicaid

Avg $98 · 35 days

Commercial

Avg $218 · 22 days

Self-Pay

Avg $164 · 45 days

Denial categories

denial-workbench · recovery queue4 CODES
CODEREASONVOLUMERECOVERY
CO-16Claim lacks information34278%
CO-45Charges exceed fee schedule21812%
CO-97Payment included in allowance1565%
PR-1Deductible amount89294%

HIPAA boundaries

  • PHI Processing ZoneRestrictedAuthorized clinical and billing staff only
  • De-Identified Analytics ZoneControlledFinance and operations analytics teams
  • BAA Partner ZoneContractedThird-party vendors under active BAA
  • Public Reporting ZoneOpenRegulatory filing and public disclosure

Compliance controls

  • Access LoggingHIPAA §164.312(b)Continuous
  • EncryptionHIPAA §164.312(a)(2)(iv)Enforced
  • Audit ControlsHIPAA §164.312(b)Automated
  • Transmission SecurityHIPAA §164.312(e)Enforced