Close the loop between billing intent and payer outcome.
Connect your 837 claims, 835 remittances, and EOBs into daily, actionable intelligence. See exactly why claims get denied, what can be recovered, and what to fix before the next claim goes out.
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Three streams. One single source of truth.
Upload a batch of 837, 835, and EOB files, or let CoOrdio ingest them automatically. Works with the clearinghouse downloads you already have — no integration, no implementation project, no waiting on IT.
Three Intelligence Layers
Three data streams. One clear revenue story.
Where the money is
Recover More Revenue
Every denied dollar sorted into one of three buckets — so teams know what to fix, what to appeal, and what is about to expire.
Preventable — fix the process so it never repeats
Recoverable — appeals ranked by likelihood of payment
Lost revenue — dollars at risk before timely filing closes
Total denied, recoverable revenue, highest-value appeals, and revenue about to expire
Paid vs. Denied Outcomes
Root-Cause Payer Intelligence
Not what the policy manual says — what each payer actually did. By connecting 837 submissions to 835 outcomes, we reveal real adjudication patterns.
Denial rates — and root-cause reasons by payer
Evidence chain — map what was billed directly to what was paid
Emerging trends — new denial patterns detected as they emerge
Procedure insights — code-specific denial behaviors
Documentation present on paid claims but missing on denied ones — a payer guideline built from real behavior
The full financial picture
Beyond the Denial
Connect EOBs to remittance data to understand underpayments, patient responsibility, and true contract performance.
Underpayment detection — expected vs. actual reimbursement
Patient responsibility — clarity from human-readable EOBs
Contract tracking — underperforming contracts and payment delays
Financial impact — financial impact by payer, trended over time
The definitive artifact a CFO carries into payer contract negotiations
Dashboard Experience
A daily cockpit for your revenue cycle.
Instead of waiting months for an outdated spreadsheet, CoOrdio Insights gives your team daily, actionable intelligence. See the exact dollar value of preventable, recoverable, and expiring revenue.
Daily Updates
Refreshed every 24 hours directly from your remittance data.
Actionable Intel
Not just what denied, but exactly what to fix and how.
Enterprise-grade
Reporting scales seamlessly across providers and practice groups.
Payer Intelligence: Fixable Denials
Top recoverable opportunities based on actual adjudication behavior.
| Payer & Reason | Volume | Impact |
|---|---|---|
UnitedHealthcare Missing Modifier 25 | 245 claims | $42,100 |
Medicare Medical Necessity (LCD) | 189 claims | $38,500 |
Aetna Authorization Not on File | 118 claims | $21,400 |
Anthem BCBS Timely Filing Expired | 42 claims | $18,200 |
What to Fix & How
UHC: E&M codes denying without Modifier 25
85% of E&M codes (99213, 99214) billed with minor procedures are being denied by UnitedHealthcare. This is a recent payer behavior change detected in the last 14 days.
Implement a claim scrubbing rule to require CPT Modifier 25 on E&M codes when billed same-day as 20610.
In The Product
Actionable insights at your fingertips
The tools your team needs to act on the data, built right into the platform.
Evidence Chain (837 → 835 → EOB)
Connect the original claim submission to the payer's adjudication response and the patient's EOB for complete root-cause clarity.
Appeals Workbench
Appealable denials automatically queued, prioritized by dollar value and likelihood of successful recovery.
Report Builder
Slice and dice denial and underpayment data by payer, provider, procedure, and location to pinpoint failure points.
Claims Scrubbing
Actionable scrubbing recommendations guided by your historical adjudication outcomes, not generic rules.
Risk Scoring (Roadmap)
Coming soon: Pre-submission risk scoring that predicts denial probability based on your historical 835 adjudication outcomes.
Start recovering more revenue
Schedule a 30-minute demo and see how CoOrdio Insights can turn your remittance files into a strategic advantage.
Insights FAQ
CoOrdio Insights: common questions
- What is CoOrdio Insights?
- CoOrdio Insights is a denial-intelligence platform for healthcare revenue-cycle leaders. It connects 837 claim submissions, 835 remittance files, and EOBs into daily, actionable intelligence to recover revenue and fix root causes.
- Do I need an IT implementation project to use Insights?
- No. There is zero implementation required. You simply upload a batch of 837, 835, and EOB files (or let us ingest them automatically), and the system generates actionable intelligence immediately. No waiting on IT or complex EHR integrations.
- How is the data organized?
- Insights organizes your data into three primary layers: Recover More Revenue (preventable, recoverable, and lost dollars), Root-Cause Payer Intelligence (how payers actually adjudicate based on what was submitted), and Beyond the Denial (underpayments and contract performance).
- How does it connect 837s, 835s, and EOBs?
- CoOrdio automatically maps the 837 (intent: what was billed) to the 835 (outcome: how it was adjudicated) and the EOB (context: patient responsibility and human-readable explanation) to provide a complete evidence chain for every claim.
- What is the Appeals Workbench?
- The Appeals Workbench is a feature within Insights that automatically queues appealable denials and ranks them by dollar value and likelihood of payment, so your team focuses on the most valuable recoveries first.