Turn every AR staff member into your best AR staff member.
NDS classifies every denial by type and root cause, routes each into a prioritized work queue, and gives your AR staff step-by-step resolution guidance tailored to the exact denial and the exact payer. A real-time denial dashboard gives your team and management instant visibility into denial trends, root causes, and recovery opportunities. The result: your team resolves more denials, recovers more revenue, and needs fewer people to do it.
According to a 2024 Experian Health survey, 73% of healthcare finance leaders say claim denials are increasing across payers. Yet most AR teams still manage denials through disjointed, manual workflows — sifting through remittances, researching denials, figuring out the right corrective action, and tracking follow-ups on spreadsheets.
It’s slow, inconsistent, and expensive. Junior staff don’t know the payer-specific nuances that experienced staff do. Filing deadlines get missed. And because of the time each denial takes, staff naturally focus on high-dollar denials — while a large volume of easily overturned lower-dollar denials are never worked.
The result: recoverable revenue slips away — not because the denials can’t be overturned, but because your team can’t get through the volume fast enough with the tools they have.
Imports ERA and EOB data and automatically identifies every denial and its reason across all payers.
Classifies each denial by type (eligibility, authorization, coding, bundling, timely filing, missing attachments, and more), complexity, and potential root cause — eliminating the need for staff to manually sift through remittances.
Routes classified denials into intelligent work queues based on configurable rules — by denial type, payer, dollar amount, complexity, or any combination your organization defines. Prioritizes denials by recovery potential and financial impact so your team works the highest-value items first.
Every denial is tracked from intake through resolution — configurable to focus on the denials most impactful to your bottom line. Nothing slips through the cracks.
Customizable reporting with visual trends across denial reasons, aging buckets, and payer performance — not just raw data, but actionable insights.
Displays key financial metrics that help management understand the financial health of denials, identify problematic trends early, and make informed operational decisions.
Enables root cause analysis across payers, denials, providers, and procedures — so you can address the upstream issues driving denials, not just the symptoms.
A custom LLM trained on denials, corrective actions, and payer-specific guidelines provides your AR staff with step-by-step resolution guidance for each denial — tailored to the exact denial and the specific payer.
Guidance is presented directly within the workflow interface. Staff know exactly what to do next — without time-consuming research or phone calls to the payer.
Every action step taken is tracked and recorded against the claim, ensuring accountability and guaranteeing no denied claim falls through the cracks.
The system continuously learns from denials that are successfully overturned, refining its recommendations over time — capturing your organization’s institutional knowledge and making it available to every team member.
For high-volume, repetitive denial scenarios, NDS connects to your EMR via API to execute automated actions in bulk — from submitting medical records and eligibility verifications to generating corrected claims. This removes entire categories of manual work from your team’s plate, freeing them to focus on complex, high-value cases that require human judgment.
Denials that were previously written off because staff couldn’t get to them are now tracked, prioritized, and resolved — including the high volume of lower-dollar denials that are easily overturned but never worked. Fewer write-offs means direct net revenue growth.
AI-powered guidance and automated routing mean each AR staff member handles a higher volume of denials — with better accuracy and faster resolution. You need fewer people to recover more revenue, reducing your overall RCM costs.
Every denial is classified, routed, and tracked from intake through resolution. Filing deadlines are flagged. Actions are recorded. No denial ages into a write-off because nobody noticed it.
Customizable reporting and a real-time denial dashboard give leadership clear visibility into denial trends, aging, payer performance, and recovery rates — enabling data-driven decisions instead of guesswork.
Most denial management tools automate routing and reporting. NDS goes further — our AI tells your staff exactly what to do for each denial, learns from what works, and gets smarter over time.
Our custom large language model is trained specifically on denials, effective corrective actions, and payer-specific guidelines. It doesn’t give generic suggestions. It provides step-by-step resolution guidance tailored to the exact denial and the exact payer — directly within your team’s workflow.
The system analyzes data from denials that are successfully overturned and continuously refines its recommendations. Over time, guidance becomes progressively more accurate — capturing your organization’s institutional knowledge and making it available to every team member.
Our AI is built on a payer intelligence layer that understands payer-specific denial behavior, guidelines, and resolution patterns. Your staff get payer-aware guidance from day one — not generic follow-up steps that ignore how each payer actually works.
Our denial management is designed to augment your AR team. The AI handles classification, routing, research, and guidance. Your staff make the decisions and take the actions. The goal: make every staff member perform like your top performer. That’s the NDS model.
NDS AI-Assisted Denial Management is designed for healthcare organizations where denial volumes are growing faster than AR teams can keep up — and where manual workflows are leaving recoverable revenue on the table.
Multi-specialty physician groups and large practices
Standalone hospitals and hospital-based billing operations
Hospital groups and Integrated Delivery Networks (IDNs)
RCM companies managing denial follow-up at scale across multiple clients
Organizations looking to reduce dependency on outsourced AR teams
Share a sample of your remittance data and your organization’s business rules, and we’ll return a working proof of concept showing how NDS classifies, prioritizes, and routes your real denials — tailored to your payers and denial patterns. No setup cost. No commitment. Just proof.
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