SaaS Designed For Hospitals Coding Inpatient Claims
Every accurate hospital claim deserves to be paid the first time.
Protect revenue by catching inpatient claim errors before they hit the payer. Orchid's CodeGuard is your frontline defense against costly inpatient claim coding errors. Our patient-pending system validates inpatient claims for accuracy, completeness, and compliance. Our solution addresses issues before they reach payers, preventing denials, thereby accelerating your payments. The Result: Fewer denials, faster payments, and a healthier bottom line.
Hospital Strain: Cash Bleeds While Claims Stall
Millions Leave Your Hospital, Without Ever Leaving the Payer’s Bank
15.7% MA vs. 3.9% Medicare
Payer mix drives denial risk. Medicare Advantage denies claims at 4x the rate of Traditional Medicare.²
$14k Average Denied Inpatient Claim
With 60% of denials never reworked, this represents a massive, preventable loss of earned revenue.³
10% Coder Error vs. 69% Doc Gaps
Only 1 in 10 downgrades are simple coder mistakes. Most are clinical validation disputes where documentation fails to support the code.⁴
Most Denials Are Preventable Noise
Over half of private-payer denials and 75% of Medicare Advantage denials are reversed on appeal, proof that the costly rework cycle is unnecessary.⁵
Introducing: CodeGuard
We help hospitals eliminate coding friction.
Swift Claim Validation
CodeGuard accelerates claim build time by performing near-real-time analysis of inpatient claims before they leave the door, providing your personnel with insights faster, allowing them to build accurate claims more quickly.
Transparent and Actionable
Hospital Billing Staff see transparent, explainable, and actionable plain-language guidance to create a compliant, clean claim. This is inside existing workflows (Epic, Cerner, etc.) or within our UI.
Clean Claim, the First Time
The optimized encounter is correctly coded to align with medical records, patient-specific payer requirements, and regulatory guidelines, thereby optimizing first-pass acceptance, facilitating faster payments, and improving A/R days.
Denials Slashed and Rework Mitigated
Fewer denials, faster cash, stronger margins. Hospitals receive payment faster through clean, citation-supported submissions because payers accept accurate, complete, and compliant claims.
Ready to Curb Denials? Request a Demo
We'd love to meet you to understand your needs and share how CodeGuard can help.