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Shifts revenue cycle management from reactive denial recovery to proactive denials prevention, helping providers protect revenue before claims are submitted
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Uses AI trained on billions of institutional and professional claims to identify high-risk claims, pinpoint root causes, and recommend corrective actions before submission
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Delivers dynamic, payer-specific intelligence and line-level visibility that help organizations avoid denials by addressing coding, documentation, authorization, and reimbursement risks with greater precision
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Extends the power of FinThrive Fusion®, the industry’s first data intelligence platform for healthcare revenue operations, helping hospitals reduce avoidable denials, accelerate reimbursement, and maximize revenue
FinThrive, Inc., a leading healthcare revenue management software-as-a-service (SaaS) provider, announced the launch of Denials Prevention Manager, an advanced AI-powered solution designed to help hospitals and health systems proactively catch denials that are often written off or missed entirely, while enriching FinThrive Fusion with higher-quality claims data to power advanced analytics and AI-driven insights.
While most revenue cycle solutions focus on analyzing denials after the fact, FinThrive’s Denials Prevention Manager uses historical claims data and advanced machine learning to identify claims with a high likelihood of denial. Beyond flagging risk, the solution provides actionable insights that help revenue cycle teams address potential issues, such as correcting coding, documentation gaps or authorization, and payer-specific billing patterns, before claims are sent to payers. As payer behavior evolves, the AI continuously learns from real-world adjudication outcomes, helping organizations stay ahead of changing payment practices that static rules-based approaches often miss.
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Denials Prevention Manager complements FinThrive’s Denials and Underpayments Analyzer, creating a continuous feedback loop across the revenue cycle. While Denials Prevention Manager helps prevent denials before submission, Denials and Underpayments Analyzer captures denials and underpayments that occur after adjudication, helping organizations continuously improve performance and reduce revenue leakage.
“Healthcare organizations have been stuck in a reactive cycle by chasing denials after revenue is already lost,” said Hemant Goel, Chief Executive Officer at FinThrive. “Denials Prevention Manager fundamentally changes that equation. We’re giving providers the ability to anticipate payer behavior, take action to prevent denials before they occur, and protect revenue before it falls through the cracks.”
From Reactive Denials Management to Proactive Denials Prevention
Denials remain one of the most significant sources of revenue leakage for healthcare organizations. Up to 10 percent of claims are denied, and denial-related write-offs have risen sharply in recent years, creating significant financial pressure for providers.
With many denials considered avoidable, over 85 percent in some analyses, AI-enabled denial prevention can help organizations take proactive action before millions of dollars in revenue are lost. Yet, most tools rely on payer policies that fail to reflect how claims are assessed in practice.
Denials Prevention Manager integrates directly into FinThrive Claims Manager validation processes, serving as an intelligent layer that continuously learns, based on billions of institutional and professional claims and how payers actually adjudicate claims. Once released, claims flow into FinThrive Fusion, where they contribute to a unified data foundation that powers enterprise-wide insights, benchmarking, and AI-driven optimization across the revenue cycle.
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“What stood out about Denials Prevention Manager is the visibility it gives our team before claims ever leave the door,” said Christopher Abbondanzo, Director, Revenue Cycle, Riverside Health System. “Instead of reacting to denials weeks later, we can now intervene in real time. That has the potential to reduce cost-to-collect and improve cash flow significantly.”
This level of insight transforms denials management from a reactive process into a proactive strategy, equipping providers with the intelligence needed to respond faster and operate with greater confidence.
“Our goal in adopting Denials Prevention Manager is to bring more structure and accountability to how we manage denials,” added Amy McNeal, Director, Denials and Insurance Follow-up, Riverside Health System. “We’re looking to use its insights to identify where issues originate and ensure they’re addressed by the right teams, such as routing coding-related denials back to coding before claims are submitted.”
