ClaimShield stops you from leaving revenue on the table in the claims you're already filing.
ClaimShield is AI-powered revenue cycle management for home health and behavioral health agencies. We catch denials before they happen, automate eligibility and prior auth, and recover the revenue that gets lost in every manual billing process.
Manual billing was never built for this volume of complexity.
Denials that disappear into a queue
A claim gets denied. Your billing team puts it in the rework pile. 30 days later it's still there. The payer window is closed.
Eligibility checked at the wrong time
Insurance is verified at intake. By the time of service, coverage has changed. The claim comes back denied, and the agency eats it.
VA Community Care complexity
PGBA EDI requirements, authorization chains, and coordination of benefits create denial patterns that generic billing software misses entirely.
No attribution on denial root causes
You know your denial rate. You don't know which payers, codes, or workflow failures are generating it.
AI catches what your billing team can't keep up with.
Pre-claim scrubbing
Every claim reviewed against payer-specific rules before submission. Errors caught before they become denials.
Real-time eligibility
Automated eligibility verification at the moment it matters, not days before service when everything can change.
Denial pattern intelligence
Machine learning identifies payer-specific denial patterns and adjusts claim submission logic automatically.
Managed recovery
Denials that get through are routed to our managed recovery team, tracked to resolution, and attributed back to root cause.
What a functioning RCM operation looks like.
Reduction in denial rate, pilot data
Faster average days-to-payment, pilot data
Collections fee, no per-seat, no platform fee
ClaimShield paid for itself in the first month. We recovered denials we'd written off and our billing team finally has a system that works with them, not against them.
Your next denied claim is already in your queue.
Book a 30-minute ClaimShield demo. We'll audit your current denial rate and show you exactly what we'd catch.