Specialties We Serve
Every specialty has its own denial patterns, payer quirks, and documentation requirements. Cookie-cutter solutions miss the nuance. H9K builds systems that speak your payers' language for your specific procedures.
The Challenge
Orthopedic practices face some of the highest denial rates in specialty medicine. MRI pre-authorizations rejected for insufficient clinical justification. Surgical claims denied for missing precertification. PT referrals in prior auth limbo. Common culprits: CO-197, PR-204, and CO-4.
How H9K Fixes It
Our AI is trained on orthopedic-specific payer requirements. The Prior Auth Pre-Screener checks every MRI and surgical authorization against exact criteria before submission. The Appeal Packet Builder generates appeals using the specific medical necessity language UHC, Cigna, and Blue Cross reviewers approve. The Denial Classifier identifies patterns to fix root causes.
Get Your Free Ortho Denial AssessmentAverage ortho denial loss:
$120,000–$250,000/year
Typical H9K recovery:
50–65% within 90 days
The Challenge
Echocardiograms denied for lack of medical necessity documentation. Stress tests flagged for missing prior authorization. Cardiac cath claims rejected because clinical notes lacked specific payer language. High-value procedures with equally high-value denials.
How H9K Fixes It
System maps common cardiology procedures to each payer's approval criteria. Pre-Screener catches documentation gaps. Appeal Builder uses cardiology-specific language from the Payer Intelligence Vault.
Get Your Free Cardiology Denial AssessmentAverage cardiology denial loss:
$150,000–$350,000/year
Single echo denial:
$800–$2,500
The Challenge
Advanced imaging is the prior auth battlefield. Nearly every MRI, CT, and PET scan requires pre-auth, and payers are tightening criteria. Denial rates can exceed 15%, each representing $500–$5,000 in lost revenue.
How H9K Fixes It
Prior Auth Pre-Screener built for imaging workflows. AI cross-references clinical documentation against ordering payer's current criteria. Denial Classifier tracks imaging-specific patterns and alerts when payers change criteria.
Get Your Free Imaging Denial AssessmentImaging denial rates:
Up to 15%+ of claims
Revenue at risk per denial:
$500–$5,000 each
The Challenge
Most opaque payer requirements in healthcare. Session limits vary by plan. Medical necessity disputes. Prior auth changes without notice. Many practices accept high denial rates as unavoidable—but they shouldn't.
How H9K Fixes It
AI tracks BH-specific payer policies and session limits. Pre-Screener flags auth requirements before sessions. Appeal Builder addresses specific medical necessity criteria. Payer Intelligence Vault gives real-time visibility into tightening coverage.
Get Your Free Behavioral Health Denial AssessmentPayer requirement opacity:
Highest in healthcare
H9K coverage tracking:
Real-time policy updates
Our AI denial management system can be configured for any specialty with significant denial volume. If your practice is losing more than $50,000/year to denied claims, we can help.
Book a Call to Discuss Your Specialty