Specificity Gap
70%
Notes lack CPT/ICD specificity
Incomplete documentation and inaccurate coding aren’t just compliance risks — they’re massive revenue leaks. Studies show that 70% of provider notes lack CPT/ICD specificity, coders spend 20–30% of their time hunting for missing data, and 15–20% of manual coding attempts contain errors. The result: underbilling, denials, compliance penalties, and delayed reimbursement.
DenialShield is the next-generation denial management platform built for this reality. Combining agentic AI, real-time monitoring, and a continuous learning loop, DenialShield stops revenue leakage at the source, while dramatically reducing rework costs and administrative strain.
Healthcare organizations using DenialShield are seeing up to a 46 percent reduction in preventable denials, faster approvals, and measurable improvements in cash flow. This is more than technology it’s a strategic advantage for providers competing in an era of razor-thin margins and intense operational pressure.
U.S. Market Overview
Notes lack CPT/ICD specificity
Retrieving buried EHR data
Missed revenue & audit exposure
CMS & payers tightening
Wasted = retrieval/navigation; Productive = review/coding.
Lowering errors reduces missed revenue and audit exposure.
Relative index (illustrative) across key drivers.
Indexed to 100 in 2020 (illustrative to show direction of change).
Global Perspective
Outside the U.S., similar patterns emerge. The U.K.’s NHS loses hundreds of millions annually to rejected claims from private payers and cross-border billing. In Australia, denial rates have increased by 12% in three years due to evolving insurer requirements. Even in emerging markets, where payer systems are less mature, claim errors and disputes lead to significant cash flow disruption. The reality is clear: the denial problem is not local-it is universal. Providers everywhere are struggling to keep pace with payer policy changes, evolving documentation rules, and new compliance mandates.
Integrated directly into the EHR, ChartAI nudges providers to include missing clinical details during documentation, ensuring note completeness upfront.
Automatically generates CPT and ICD codes with confidence scores and explainable rationale, giving coders precise insights into AI recommendations.
Provides full coder override and audit trail features, combining automation with expert human judgment.
RevenueShield learns from coder decisions, payer feedback, and audit outcomes to continually improve coding accuracy.
evenueShield combines natural language processing (NLP), explainable AI, and clinical knowledge models to optimize documentation and coding.
For a 1,000-provider health system
Leads to lost reimbursement
Target reduction range
Per year
Coders focus on complex cases
Eliminating 15–20% coding errors can retain $10M+ annually. Productivity gains free coders to focus on complex cases, reducing staffing pressure.