Signal source A
Payer rule library
Real-time access to 5,000+ payer-specific editing rules — LCD/NCD policies, modifier requirements, and bundling edits — cross-referenced against every outgoing claim before it leaves the queue.
Predictive revenue intelligence
Revenue cycle analytics that predict claim denials. See what happens next.
VOSKPO Analytics replaces lagging reports with predictive intelligence — denial risk scored before submission, 30/60/90-day cash flow forecasts, and under-coding alerts that surface revenue you've already earned but haven't yet billed.
- 10k+
- Claims risk-scored daily
- 94%
- Cash-flow forecast accuracy
- < 2%
- Residual denial rate (post-AI)
Pre-submission denial scoring
The AI reads every claim before the payer does.
Our engine evaluates four signal sources simultaneously, produces a single risk score for every claim, and routes anything high-risk for correction before transmission — not after the denial has already cost you the wait.
Denial risk score (0 – 100) · Illustrative
Lower is cleanerLow · 0–30Moderate · 31–65High · 66–100
VOSKPO avg
Signal source B
Historical denial patterns
The model learns from your practice's own denial history, identifying which payer, code, and modifier combinations carry an elevated failure rate and weighting the risk score accordingly.
Signal source C
Real-time eligibility status
Live eligibility verification runs at the moment of scoring — confirming active coverage, co-pay and deductible status, and prior-authorization requirements before the score is finalized.
Signal source D
Code-level risk factors
Procedure and diagnosis code combinations are analyzed together, flagging clinically unlikely pairings, modifier stacking errors, and high-scrutiny codes that payers audit at elevated rates.
What happens when a claim is flagged
- 01
Score assigned pre-transmission
Every claim receives a 0–100 risk score before leaving the queue. Claims scoring below the threshold transmit immediately, with no human touch required.
- 02
High-risk claims routed for review
Claims above the risk threshold are flagged and routed to a billing specialist for targeted intervention, correcting the issue before the payer ever sees it.
- 03
Corrected claim transmits clean
After intervention, the corrected claim is re-scored, confirmed clean, and released — preventing the denial that would otherwise trigger a 30 to 90 day rework cycle.
Risk models retrain weekly on aggregated payer rule updates and integrate directly with your EHR and practice management system — no separate data entry.
Revenue yield analysis
The revenue you billed — and the revenue you didn't.
Most practices leave 8–15% of collectible revenue uncaptured through systematic under-coding, unbilled ancillaries, and sub-optimal modifier usage. VOSKPO's AI finds every dollar of it.
Under-coded procedure detection
Our AI cross-references submitted codes against documentation-supported complexity, flagging visits billed at 99213 when the clinical notes actually support 99214 or higher.
Payer fee schedule arbitrage
We benchmark your contract rates across every payer panel, identifying procedures reimbursed below the median in-network rate and flagging them for renegotiation.
Missed ancillary billing
We detect ancillary services performed but never billed — tests ordered, supplies used, procedures completed — that quietly compound into significant missed revenue at scale.
CPT modifier optimisation
Modifier analysis identifies procedures where adding the correct modifier — such as -25, -59, or -RT/-LT — would prevent bundling denials or unlock separate reimbursement entirely.
Predictive cash flow
Know your cash position 90 days out.
Staffing, equipment, and expansion decisions shouldn't run on gut feel. Our forecast models give your practice CFO a modeled cash position to plan against — not a guess based on last month's bank balance.
30 Day forecast
$284,000
Projected net collections · Illustrative
High confidence · 94%Weekly projection trend
Wk 1Wk 2Wk 3Wk 4
Model confidence94%
Driven primarily by clean-claim submission velocity and your current payer mix over the period.
This forecast draws on your confirmed A/R pipeline and each payer's historical payment cycle.
60 Day forecast
$611,000
Projected net collections · Illustrative
Moderate confidence · 87%Weekly projection trend
Wk 1Wk 2Wk 3Wk 4
Model confidence87%
Driven by seasonal volume trends and any contract renegotiations currently in progress with your payers.
Incorporates expected volume changes and payer-mix shifts building on the 30-day forecast window.
90 Day forecast
$1.04M
Projected net collections · Illustrative
Directional forecast · 79%Weekly projection trend
Wk 1Wk 2Wk 3Wk 4
Model confidence79%
Driven by your practice's growth trajectory and broader payer reimbursement trends across the market.
The confidence band widens at this horizon — treat this as a directional range, not a point estimate.
Payer payment velocity model
The model maps each payer's average days-to-payment, projecting precisely when each A/R bucket converts to cash.
Denial probability adjustment
Pre-submission denial risk scores feed directly into the forecast — high-risk claims are discounted until they're confirmed clean.
Forecast models retrain monthly against aggregated payment data and are validated for accuracy each quarter. All figures shown are illustrative and based on representative client profiles, not guaranteed outcomes.
From the blog
The data behind the decisions.
- Why Claim Denials Are Surging in 2026: The Triple Threat
Prior authorization, NCCI bundling edits and payer AI are converging on claims at once in 2026. Here is the three-force breakdown, and the prevention plan that stops all three before they become denials.
- Navigating the Q3 2026 CMS & NCCI Updates: How to Protect Your Cash Flow
The Q3 2026 CMS/NCCI updates hit July 1 with new HCPCS codes, Add-On Code edits, and the removal of the AX modifier. Here's how to avoid the CO-97 denial spike and the cash-flow freeze that follows.
- Prior Authorization in 2026: Stop the 31% Denial Spike
CMS-0057-F was supposed to simplify prior authorization. Instead it made data-field precision mandatory, and independent practices are absorbing a 31% denial spike. Here is the PA-first workflow that stops it.
See it live
See every missed dollar in your A/R — in 30 minutes.
Bring your own payer mix to a live walkthrough of the dashboard — no commitment required. You'll leave with a denial risk sample, a cash flow snapshot, and a yield gap report built from your own data.
What you'll see
- Live denial risk score on a sample claim batch
- 30/60/90-day cash flow forecast model with your practice's payer mix
- Revenue yield heatmap — under-coded procedures flagged in real time
30-minute session · No obligation · US providers only