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The ShieldAI platform

One platform, working every stage of the claim lifecycle.

ShieldAI runs inside the EHR you already have — no migration, no rip and replace. It is included with every SCALE engagement rather than licensed separately, and a specialist team works alongside it.

ShieldAI one platform, every stage FRONT-END FrontDeskShield MID-CYCLE RevenueShield BACK-END DenialShield
01 · Capability

Eligibility & verification

Coverage, benefits, and authorization confirmed before the patient arrives — automatically, across every appointment on the schedule.

FrontDeskShield

1Reads tomorrow’s scheduleEvery appointment, across every location, without anyone opening a worklist.
2Verifies coverage and benefitsDirectly against payer files — plan status, deductible, copay, and secondary coverage.
3Checks authorization statusSubmits where it can, tracks what is pending, and re-checks until it resolves.
4Escalates only the exceptionsTerminated plans and stuck authorizations route to a specialist with the context attached.
208 of 214Cleared with no human touch
1.4%Registration error rate
96.8%Clean claim rate
Patient access · tomorrow's schedule 214 appointments SHIELDAI runs overnight, before anyone opens the queue Eligibility verified 208 Auth status refreshed 61 Coverage changes caught 9 YOUR SCALE SPECIALIST picks up only what needs a person · 6 of 214 M. Alvarez · 9:15 AM plan terminated — new coverage located, calling to confirm J. Whitfield · 10:00 AM auth pending for 64483 — escalated to payer rep Everything else cleared without a human touch
02 · Capability

Revenue integrity

Every encounter checked against every charge, so documented work reaches a claim at the level it was actually performed.

RevenueShield

1Reads encounter documentationClinical notes matched against the charges that were submitted for the same visit.
2Flags missed chargesWork that was documented but never billed, surfaced the same week rather than at year-end audit.
3Identifies under-codingEncounters coded below the documented level of service, by provider and specialty.
4Routes to certified codersEvery flag reviewed by a person before anything changes on a claim.
98.6%Coding accuracy
$1.8MRecovered year to date
Same weekTime to surface a gap
Coding & charge capture · this week 42 providers SHIELDAI reads every encounter against every charge Revenue recovered · $ thousands Recovered year to date $1.8M YOUR SCALE CODER works the flags, holds the accuracy 7 encounters documented, never charged $8,240 · ortho · resolved same day Coding accuracy 98.6% Under-coding flags cleared same week
03 · Capability

Denial prevention

Claims scored against how your payers actually behave — corrected before submission, and appealed with precedent when they still deny.

DenialShield

1Scores every claim pre-submissionRisk assessed by payer, CPT, location, and provider before anything is sent.
2Corrects what it canRoutine issues fixed automatically, with the correction logged and auditable.
3Prioritizes the rest by valueWhat needs a person arrives ranked by dollars at risk, not by date received.
4Drafts the appealDenials come back with a letter already written, citing precedent from prior overturns.
50%+Fewer denials
1,032Corrected automatically per day
3.1%Denial rate, from 7.4%
Claims & denials · today 1,284 claims SHIELDAI scores every claim against payer history before it goes out 3.1% denial rate · was 7.4% Corrected automatically 1,032 no human touch Flagged for a person 146 highest value first YOUR SCALE SPECIALIST reviews the draft, sends the appeal Appeal drafted · CLM-87903 · United · $4,120 CO-197 · precedent from 34 similar overturns cited Review & send Claims that used to deny now pay within 30 days ~51% of the time up from ~18% before ShieldAI
04 · Capability

Analytics

One view across every location, payer, and provider — with peer benchmarks, so you know whether a number is good or just familiar.

RCM Analytics

1Consolidates every siteOne data model across locations, specialties, and practice management systems.
2Benchmarks against peersYour performance measured against SCALE’s operating book, not a published industry average.
3Surfaces problems earlyTrends flagged as they emerge rather than described in a month-end report.
4Full audit trailEvery claim touch, automated or human, traceable end to end.
LiveNot month-end
By payer & siteDown to provider level
FullAudit trail on every touch
Enterprise analytics · 38 locations Updated live Net collection97.1% Days in A/R28.4 Denial rate3.1% Clean claim rate 96.8% Performance trend 12 months Payer vs benchmark Aetna United BCBS Medicare Site ranking · net collection rate Northside98.4% Westgate97.6% Lakeview97.1% Midtown96.2% Riverside95.8% + 33 more sites
How it runs

Inside your systems, not alongside them

EHR-native

ShieldAI reads and writes inside the system your team already uses. No data migration, no second application to learn, no parallel worklist.

Proof before scale

We run your own claims and denials through the platform first, so the opportunity is sized against your data rather than an industry benchmark.

Auditable by design

Every automated action is logged and traceable. Nothing changes on a claim without a record of what changed and why.

Works with the systems you already run

EpicathenahealtheClinicalWorksNextGen Modernizing MedicineGreenwayAllscriptsDentrix
ISO 27001ISO 9001SOC 2 Type II HIPAA compliantUS-based Azure (Tier III)No offshore data transfer

See it against your own data

Bring us a month of claims and denials. We'll show you where the money is going and what we'd do about it — before you sign anything.

Book a demo