Denial prevention
RCM automation that stops denials before they start.
We build automation inside the systems you already use, so fewer claims deny in the first place. Official connections only.
Fixed-price projects, scoped in writing
Who it is for
- Programs where eligibility and auth checks eat staff hours
- Billing teams chasing claim status by phone or portal
- Anyone missing appeal deadlines because nobody tracks them
What you get
- Eligibility and benefits checks on a schedule, not only at admission
- Authorization status checked against each claim before it goes out
- Claim-status follow-up through your clearinghouse
- A denial and deadline dashboard by payer
- Corrected-claim resubmission with the right frequency code and claim number
How it works
- Step 01
Scope in writing
We map the manual steps and agree on what gets automated, for a fixed price.
- Step 02
Build in your systems
We connect through your clearinghouse and payer APIs. No portal bots, no screen scraping.
- Step 03
Run and hand off
We run it with your team, log every action and document how it works.
Pricing
Fixed-price projects, scoped in writing.
Fixed-price projects, scoped in writing before work starts. Optional monthly upkeep after launch.
What we commit to
- Report in 10 business daysYour denial review report within 10 business days of receiving a de-identified export.
- Specialist approvalEvery appeal is approved by a specialist before it is sent.
- Logged and reportedEvery action is logged. You get a report every week.
- BAA before PHINo patient data until a BAA is signed, plus a Part 2 agreement for SUD records.
Commitments about how we work, not promises about payer decisions.
Questions
Do you replace our EMR or clearinghouse?
No. We work inside the systems you already use, such as Kipu, Lightning Step, Sunwave, Alleva, CollaborateMD or Waystar.
Do you use bots on payer portals?
No. We use clearinghouse and payer APIs. Where a payer only accepts portal submissions, a person submits.
Who owns what you build?
That is set in the project agreement, in writing, before work starts.
Other services
- Fixed fee from $1,250Denial auditA short, fixed-fee report built from your own remits and aging. It starts de-identified, so no patient data is needed.Read more
- You pay only on dollars recoveredDenial recoveryWe work the commercial denials your team does not have time for: medical necessity, level of care, authorization and aged A/R follow-up.Read more
Next step
Book a denial review.
Twenty minutes. No patient data needed.
Or email hello@skygathering.com