Prevent / Ongoing support
Address the problems before they become another loss.
Help your team resolve claim issues earlier and address recurring sources of denied or underpaid reimbursement.
Discuss preventionWhat the practice receives
Clearer priorities.
Practical follow-through.
Issues that need attention
Review findings help your team identify claims that need clarification, correction, or supporting information before submission.
A record of what changed
Keep the reviewed claim and subsequent corrections clear so your team knows which information supported the handoff.
Visibility into recurring problems
Use subsequent payer outcomes to understand what continues to cause rework and where further attention is needed.
An example of useful support
A finding should help
someone take action.
Your team needs to know what requires attention, what information is missing, and what should happen next.
Information needed before handoff
- Issue identified
- Supporting information is incomplete
- Next step
- Confirm the required information with the responsible team
- Review status
- Awaiting clarification
An example of a review finding, not a prediction that a payer will deny or pay a claim. Actual findings depend on the available information.
One ongoing relationship
Prevention support.
Recovery included.
Prevent uses a recurring retainer based on the volume your practice runs. Recovery is included within the agreed scope, so you can address existing losses while working on what comes next.
Define the scope together
Agree on claim volume, review responsibilities, reporting, and the recovery work included in your engagement.
Work with your billing operation
Your practice retains responsibility for clinical decisions and the agreed submission process. Prexisio provides the review and support defined in your engagement.
Evaluate actual outcomes
Review findings and subsequent payer responses help assess progress. We distinguish observed changes from claims that Prexisio caused a particular reduction in losses.
Questions about Prevent
Understand the service
before you commit.
Must we start with Recover?
No. We can discuss Prevent directly. Historical claims and payer information help establish an appropriate starting point and scope.
Does a reviewed claim have guaranteed payment?
No. Payers make adjudication decisions. Review can help surface issues for attention, but it does not guarantee approval or reimbursement.
Will Prexisio replace our billing system?
That is not a requirement of this service. We agree on how information and reviewed work will move between your team and Prexisio during onboarding.
How is the retainer determined?
The retainer is based on volume and the agreed engagement scope. We establish those terms, including included recovery work, before the service begins.
A practical next step
Which problems keep coming back?
Tell us where your team is seeing repeated denials, payment shortfalls, or claim rework.