Features
Real-time reimbursement risk prediction as care is documented
Clinical root cause identification linked to documentation patterns
Payer-specific payment outcome modeling
Role-specific prevention recommendations for UR, CDI, Coding, PFS
Pre-bill underpayment and DRG downgrade probability scoring
Validation and learning from every claim outcome
Workflow integration via Sift UI, embedded in EHR, or partners
Retrospective audit detection (level-of-care downgrades, takebacks)
Denial overturnability analytics for appeals prioritization
Revenue recovery tracking and ROI measurement over time
Proprietary MS-DRG playbooks (329 total) powering actionability
Normalization of clinical and financial data (692 data elements)
Adoption and throughput lift tracking at user and workflow level
Denial prevention by payer, DRG, service line, and process
Pre-bill prevention rather than retroactive denial management
Prebill Optimization Suite: unified coding & CDI
Coding Optimizer: surfaces missed coding opportunities
CDI Optimizer: closes documentation gaps
AI Advisor: revenue cycle research assistant
Auth Status: automated authorization checks
Claim Status: automated claim follow-ups
GenAI trained on clinical & financial data
Integration with Epic, Cerner, Meditech
13% average reduction in A/R days
300+ hours staff time saved per month
650+ hospitals and 6,500+ outpatient facilities
Generative AI optimized for healthcare RCM
