Meet Daniel — Red Sky Health’s cutting-edge human-augmented AI platform built to take the fight to denied claims. Daniel empowers healthcare providers to recover revenue fast by instantly identifying errors, fixing them in real time, and resubmitting with precision. No delays. No missed dollars. Just results.
Daniel uses machine learning (ML) and GenAI models to pinpoint and fix claim errors, reducing denials and accelerating revenue recovery — all with seamless automated resubmission.
1. Pattern recognition
A base model that leverages the historic billing patterns of providers along with the corresponding denial patterns of insurance carriers
2. Analysis
The next set of denials are analyzed through a suite of ML algorithms that identify key features in claims that impact the denials at the claim line.
3. Recommendation
The algorithm recommends revisions to maximize the probability of payment for that line.
4. Precision
Focusing on Precision as the key performance indicator to ensure minimal to no false positives the model is carefully tuned to control volumes analyzed.
5. Optimization
The key to model optimization is large volumes of historic paid, denied and resubmitted/paid claims.
