Minimizing work. Maximizing revenue.
Use Cases
Simplify your revenue cycle.
Cofactor integrates into your RCM process seamlessly so you and your team can get back to what you do best.
Retrospective Reviews
Fight back against retrospective reviews that deny coverage post-payment and ensure benefits are being applied correctly.
DRG and Severity Downgrades
Instantly appeal severity downgrades backed by documentation, coding guidelines, and payer policies.
RAC Audits
Instantly appeal unfair RAC audits used to extrapolate and extract resources from your facility.
Re-Admission and Clinical Necessity Denials
Instantly appeal readmission and clinical necessity denials backed by clinical documentation, standard of care guidelines, payer guidelines, and peer-reviewed studies required to overturn denials.
Features
Let's rethink the denials management process.
Our AI handles everything from generating appeal letters to predicting payment outcomes, so you don't have to. We dig into the reasons behind denials, prioritize what matters most, and give you clear steps to fix and resubmit claims — all customized to the payers' policies. It's the smart way to recover more revenue with less hassle. Here's how.
Automate responses to complex denials.
Generate appeal letters.
Fine-tuned responses to payer-specific policies.
Analyze the root cause and identify issues and reasons for claim denials.
Predict payments and denials.
Find solutions and get steps to correct and resubmit claims.
Prioritize denials and rank claims by urgency and financial impact.
Identify and categorize payer-specific information and codes.
Check claims and medical records against coding and standard of care guidelines.
Integrations
We play nice with your existing systems.
No matter what systems you’re using, Cofactor works within your current setup to streamline processes and maximize efficiency. Cofactor seamlessly integrates with your existing EMR, payer, and clearinghouse systems. That makes it easy to enhance your revenue cycle without disruption.
