Denial and Underpayment Prevention

Stop Revenue Leakage at the Source

Prevent denials and underpayments before they erode margins and inflate cost to collect

Why is preventing denials and underpayments so hard?

High claim volumes and limited resources make proactive denial prevention nearly impossible.

Achieving upfront accuracy is one of the biggest challenges in revenue cycle management. Patient identity, insurance coverage and authorization requirements must align flawlessly before care begins. However, fragmented systems, evolving payer rules and manual processes make it easy to overlook critical details. These gaps result in eligibility errors, missed authorizations and costly denials that erode margins and create a cycle of endless rework.

Submitting a clean claim is more challenging than it seems. Every payer has unique, ever-changing rules, coding requirements and documentation standards. A missing modifier or outdated code can quickly lead to costly delays and rework. Even minor errors can disrupt the revenue cycle, slowing reimbursements and adding to the administrative burden.

Maintaining payment integrity is an ongoing challenge. Complex contracts, shifting payer interpretations and manual reconciliation create blind spots that result in underpayments and lost revenue. Without real-time visibility, discrepancies often slip through unnoticed, eroding margins and leaving teams to tackle time-consuming recovery efforts long after claims are processed.

What Denials and Underpayments Prevention Looks Like

99.5%

Prior authorization rules accuracy rate

↑98%

Average clean claims rate

↓50%

Reduction in denial rate

2X

Double expected underpayment recoveries

Your Path to Preventing Denials and Underpayments

Catch errors early, recover missed revenue and protect every earned dollar.

FinThrive bridges accuracy gaps with a unified workflow that seamlessly verifies identity, insurance coverage and authorizations in a single step. Enhanced by Fusion-powered agentic AI, Access Coordinator proactively identifies missing details and automates essential tasks like authorization requests—stopping denials before they happen. By addressing every requirement up front, we minimize costly errors, eliminate rework and accelerate the submission of clean claims.

FinThrive ensures clean claims from the start with advanced pre-submission validation. Powered by our Fusion data intelligence platform, Claims Manager predicts claim and line denials before submission, enabling providers to address errors proactively. Meanwhile, Revenue Capture optimizes reimbursement and enhances clean claim rates by identifying missing revenue and resolving compliance issues before billing.

FinThrive secures payment integrity by validating every claim against payer contracts. Enhanced by Fusion, our Denials and Underpayments Analyzer integrates seamlessly with Contract Management and A/R Optimizer. Whether used alone or combined, these tools identify underpayments, spot discrepancies, and automate recovery. We also reveal the upstream patterns causing revenue leakage, empowering teams to fix process gaps, reduce repeat issues, and protect margins.

Healthcare Leaders Share How FinThrive Helped Stop Revenue Leakage

FinThrive’s Claims Manager has streamlined our claims process with seamless Epic integration, real-time feedback, and automation.

Maintaining a 98-99% clean claim rate, we’ve minimized manual tasks, focusing on high-value work. Responsive support has boosted productivity and performance.

Tameika Diggs

Senior Director of Patient Financial Services, Children’s Health of Texas

FinThrive has been a great partner, particularly with their Access Coordinator suite of products.

It has been our driving force in terms of eligibility verification and reducing front-end denials, specifically on eligibility in the first quarter of this year. We've also seen a significant increase in found insurances with the new Insurance Discovery product.

Joe Bedwell

Director, DCH Health System

For my teams and management at the frontline, FinThrive provides the necessary complexity, details, and specificity to address root causes, solve problems effectively, and implement necessary changes to prevent recurrence.

Miguel Vigo

Chief Revenue Cycle Officer, University of California, San Diego

In the past, if we had three or four out of ten denials that were false positives, the teams would lose focus on prevention efforts as they start assuming they’re going to see false positives that are not actionable.

When we can identify real denials with real dollars at risk, there is an imperative and an energy to fix the underlying issues.”

Ryan Bayne

Corporate Vice President, Systems & Analytics, Prospect Medical

We turned on FinThrive’s Contract Management tool last fall. This tool significantly eased our frustration in identifying underpayments.

It found $3M in underpayments and created noise for payers. We are now tracking overturn rate, in terms of dollars, as part of our analytics. It has been huge.”

Nicole Clawson

VP of Revenue Cycle. Pennsylvania Mountains Healthcare Alliance

Ready to prevent denials and underpayments?

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