Stop denials before they happen. Overturn them when they do.
Stop fighting machines with humans
Health plans use AI-powered technology to adjudicate your claims. Protego Health levels the playing field by preventing up to 46% of denials and reducing the time to create effective appeals by up to 91% without complex integrations or training.
Our Solutions
Guardian Denial Preventer
Flags denial risks at the point of order, clinical note, and claim creation, helping to prevent denials before claims are submitted.
Batch Analyzer
Unify open AR reporting across sites & EHRs, and organize unpaid claims by payer, age, category, or amount, with payer-specific next steps.
Guardian Denial Preventer
Preventing denials at the point of order, clinical note, and claim creation
At the point of order
When the clinician is ordering, before the patient is even seen, Guardian can verify that the diagnosis attached to the order matches the LCD/policy for that CPT. Incorrect pairings get flagged before the order is placed.
Prior to/during patient encounter
Surfaces payer-specific medical necessity and prior-auth requirements, validates diagnosis–procedure coverage for scheduled services, and flags missing clinical documentation gaps that can jeopardize payment.
Post-service support
Instantly flags denial risks - from coding errors to missing modifiers and medical necessity criteria - and recommends payer-specific fixes before claim submission.
In real time
Seamlessly updates payer policies and coding guidelines directly inside your workflow.
Easy to deploy
Overlays almost all web-based EHRs, seamlessly appearing within your workflow without any integration required.
Guardian Appeal Generator
When denials do occur, remediate complex cases up to 91% faster
Data extraction
Extracts key details from the claim and denial, including the payer, procedure, diagnosis, and denial codes.
Policy cross-referencing
Surfaces and cross references the individual payer policies and coding guidelines.
Appeal generation
Identifies the underlying issues and, where relevant, cites the individual policy/guideline and evidence from the progress note to generate claim-specific appeals.
Continuous payer intelligence
Payer policies and coding guidelines update automatically within your workflow, keeping your team aligned without the need to create manual edits or learn about policy changes only after claims are denied.
Batch Analyzer
See the full picture of your unpaid claims
Actionable analysis
Transforms raw 835/837 data into a structured, actionable work queue, with every denied claim surfacing its violation and the precise fix needed.
Organize at scale
Surfaces and cross references the individual payer policies and coding guidelines across the entire AR file.
Close the intelligence gap
Batch Analyzer applies payer-level logic to every denial and surfaces specific next steps - no research required.
How it works
Supporting your team within minutes of implementation
Compatible with nearly every
web-based EHR
No need to leave your existing workflow and no time-consuming technical integrations.
Human in-the-loop design
Protego Guardian surfaces the problems and the fixes. Your staff makes the call.
Easy to implement
Implementation is instant for most clients, providing immediate support with as little as 30 minutes of initial onboarding required.
ROI from day one
Protego Guardian's AI-powered tools have transformed how healthcare organizations manage their revenue cycle.
Up to
46%
of denials prevented
Up to
91%
time saved
researching, drafting, and submitting appeals
