Undeniably better.
Protego empowers billing teams with AI-driven tools to prevent and appeal denied medical claims.
Healthcare providers spend over $20 billion/year pursuing denied and delayed insurance claims, and lose over $750 billion to claims that are ultimately denied.
Health plans use technology to adjudicate and deny claims, while providers have relied on human capital alone to prevent and address denials... until now.
Meet Protego Health - the AI-powered denial protection solution. Protego references previously unconnected databases like payor policies and coding guidelines, and analyzes them against claims pre-submission to prevent denials. When claims are improperly denied, Protego empowers billing teams to generate complex, claim-level appeals 91% faster.
Protego can prevent denials in real time by bringing policies, coding initiatives, payment criteria and your own rules directly to the point of claim submission, flagging issues before they become lost revenue.
Protego’s appeal generator cross references ERA’s, relevant databases (payor policies, LCDs, FDA guidelines, etc), and progress notes, and generates compelling, claim-level appeals.
Protego's reference tool helps RCM teams verify medical necessity and prior auth criteria by pulling and synthesizing relevant medical policies and coding guidelines prior to service.
Protego can fight hard to win denials on your behalf, utilizing our in-house experts and AI-powered solutions. We act as an extension of your RCM team, and only take payment when you win.
“The covered app is awesome for working ERA denials! The preventative tool helps me catch mistakes before they become denials, and the appeal generator allows me to work rejections and denials 10x faster than I could before. Their tools make my daily work so much easier!”
Sara - AR specialist, 20 years experience in healthcare revenue cycle
“The answer was spot on. I am amazed!!! The answer I received was so great because it indicated that the visual field would be covered, which would send a billing representative in the right direction for a valid diagnosis/covered indication.”
Kari - RCM leader for 40-doc outpatient surgery center & Ophthalmology Group
“In under 30 seconds, I had the answer to my question, and was able to send the specific clause that indicated the need for a prior auth to my billing manager so she could call back and obtain the (needed) documentation.”
Mary - Head of Physician Billing for 28-provider independent GI group
Protego Health
Manhattan, New York
