Home · ShieldAI

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.

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

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

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%

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

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

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.