Claims & Auth Processing
Replace the back-office. We handle prior auths, claim submissions, denial appeals, and payer follow-up — under a HIPAA BAA, with a credentialed reviewer signing every escalation.
Gated on: HIPAA BAA executed with all model vendors (Anthropic Enterprise BAA in progress). AHIMA-credentialed (CCS / CPC) reviewer in-house. BAA + hire gate before flip.
Why this exists.
A billing company that takes 6-8% of collections. In-house staff doing prior auths by fax. A 30% denial rate eating margin you'll never get back.
The value stack.
- 01Prior auth submission within 4 business hours
- 02Claim scrubbing + submission with first-pass acceptance optimization
- 03Denial appeals drafted within 48 hours of EOB receipt
- 04Payer follow-up cadence — no claim ages past 45 days unattended
- 05Monthly RCM dashboard: collections, denials, days-in-AR
Or you don't pay.
If your claim acceptance rate doesn't beat 95% in month 3, the next month is on us.
Every deliverable is signed by a named reviewer with the relevant credential. HIPAA BAA executed with all model vendors (Anthropic Enterprise BAA in progress). AHIMA-credentialed (CCS / CPC) reviewer in-house. BAA + hire gate before flip.
ABN provides operations support, not licensed advice. Final filing or binding decisions require sign-off from your CPA, attorney, or licensed professional.