Nothing to set up
It reads the remittances already loaded in Denials; there is no data entry of its own.
Billing / Denial patterns
What this payer keeps refusing — read before the next claim goes out.
Every remittance already imported records what each payer refuses, for which codes and why. This reads them the other way round and warns before a claim repeats a known pattern. It warns; it never blocks.
What it does
Denial patterns, in practice
Patterns, not anecdotes
Only combinations of payer, procedure code and reason seen at least three times in the past year are shown.
Only what you can act on
Reasons the practice can fix — resubmit or appeal — count. Contractual write-offs and patient balances are left out.
The preventable share
How much was preventable in the last 180 days, and what share of all adjustments that is.
Check a claim before sending
Look up what a payer has refused a procedure code for before. A warning, never a block.
How it works
From the first step to the last
- 1
Import remittances
Denials does this as each payer file arrives.
- 2
Read the patterns
Repeated refusals by payer and code, with the reason and what they cost.
- 3
Check before sending
Look up the payer and code before the next claim goes out.
What it needs
Before you switch it on
Every module switches on and off by itself, per clinic, with its own screens, permissions and audit trail.
Worth knowing
It warns and never blocks: a pattern describes what a payer did, not what is clinically right. The check is its own page, not part of the claim checks.
See Denial patterns working on a real system.
The demo runs every module against an unmodified OpenEMR, with invented patients. Nothing to install and no sales call.