Denied Claims Remediation Powered by AI | Red Sky Health

DENIAL REMEDIATION FOR HEALTHCARE PROVIDERS

Automated claims denials remediation, powered by AI, helping healthcare providers

SEE DANIEL IN ACTION

See how denial work moves through Red Sky Health.

Walk the product yourself, at your own pace.

The platform works best on desktop. Some features may not be available on a phone.

Companies powered by Red Sky Health

CLAIMS MOVING TODAY

  • cpcREACH
  • American Medical Billing LLC
  • BillPro Management Systems
  • Medical Equity Partners

Turn denied claims into recovered revenue.

01

Claim denied

The payer says no. The revenue is still yours to work.

02

Find what went wrong

Daniel analyzes the denial and claim context.

03

Make the correction

The platform prepares the appropriate correction for the claim.

04

Move it back out

Eligible claims move toward resubmission and payment.

The platform works best on desktop. Some features may not be available on a phone.

Insurance payers automate denials. Your billing team should not have to fight back manually.

THE HIDDEN DENIAL PROBLEM

Your denial rate looks manageable. Your recovery rate tells a different story.

The recovery gap

DENIED

WORKED

UNTOUCHED

Up to 65% of denied claims are never reworked or resubmitted. Not appealed, not corrected, just written off (HFMA). In specialties like behavioral health, denial rates commonly run 15 to 25%.

41% of providers now report denial rates of 10% or more, up from 30% in 2022 (Experian Health, State of Claims 2025).

Capacity, priced per claim

CURRENT TEAM CAPACITY

A fixed number of claims worked each month

WITH RED SKY HEALTH

Added capacity, same headcount

Your team

Added recovery capacity

$47.77

PER CLAIM, MEDICARE ADVANTAGE

$63.76

PER CLAIM, COMMERCIAL

That is the cost to rework one denied claim (HFMA). A fixed billing budget buys a fixed number of claims worked, not a fixed number of dollars recovered.

Bars are illustrative. Actual capacity gain depends on your denial mix and staffing. The cost per claim is real.

Sources: HFMA, “Navigating the Rising Tide of Denials” (rework cost, resubmission rate). Experian Health, State of Claims 2025 (provider reported denial rates). Behavioral health denial rate range from industry RCM benchmarking.

Everything you need to resubmit more denied claims.

Built for the denial work your team already owns.

Automated Denial Remediation

Correct and prepare eligible denials for resubmission.

Workflow Integration

Work alongside the billing process already in place.

Resubmission at Volume

Move more eligible claims before deadlines expire.

Paid on Recovery

We get paid when your revenue is recovered, not before.

Greater Billing Capacity

Extend how much denial work your team can address.

Data Protection

Control how sensitive claim information is handled.

AI Architecture →

The platform works best on desktop. Some features may not be available on a phone.

Built for healthcare data.

Independent assurance work behind the platform that handles your claim information.

SOC 2, powered by Vanta HIPAA Compliant HITRUST e1 Certified See our AI architecture →

FAQ

Got a question? Get your answer.

Still curious after this? Ask us during a denials analysis.

We work denied claims. Red Sky Health uses AI to research the denial, prepare the appropriate claim correction, and move eligible claims toward resubmission.

No. We work alongside the people and processes already running your revenue cycle, focused on denial work that competes for limited staff time.

That is what the free denials analysis is for. We look at your current denial workload and where claims may be going untouched.

Recovery is performance based, so our model is aligned with revenue recovered. We will walk through the specifics for your organization directly.

We control how claim information is accessed, processed, and shared. When certain external AI capabilities are used, PHI stays within Red Sky Health.

See our AI architecture →

The platform works best on desktop. Some features may not be available on a phone.

See how much denied revenue may be going untouched.

We will look at your current denial workload and show you where Daniel can help.

Get a Free Denials Analysis