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Orchid Prevent

See what needs attention before you submit.

Before a claim goes out, Orchid Prevent shows your team what needs attention and why, using the payer rules and evidence that apply.

Talk through a pre-submission workflow See how Orchid works

Fix it before it goes out.

After submission, an avoidable issue can become a denial, records request, correction, or appeal. Before submission, your team can still act.

Same issue. Better moment to act.

After submission

  1. Claim submitted

  2. Issue surfaces downstream

  3. Denial / records request

  4. Rework + A/R drag

Before submission

  1. Draft claim

  2. Orchid Prevent surfaces reason

  3. Human resolves where needed

  4. Submit

Surface what deserves attention.

Payer requirements

Does the claim align with the payer rules, timing, frequency, and conditions that apply?

Claim support

Does the available documentation and claim context support what is being billed?

Claim relationships

Do modifiers, related services, frequency, or other claim details create an issue that deserves review?

Where Orchid Prevent fits.

Orchid Prevent sits before submission, showing what deserves attention and why while your team keeps the final decision.

  1. Existing claim workflow

    The systems your team already runs.

  2. The moment

    Draft claim ready

    Assembled, not yet submitted.

  3. Orchid

    Orchid Prevent

    An evidence-backed decision layer before submission.

    1. Claim context + available evidence

    2. Defensibility review

      • Appears supported
      • Needs attention
      • Uncertain

    4. Reason for attention

  4. Your team

    Qualified human action

    A person decides what happens next.

    • Continue
    • Review
    • Resolve issue
    • Route for review

  5. Existing submission workflow

    Submission remains in the system your team already uses.

Illustrative. Orchid Prevent is designed to work alongside existing claim and submission workflows; no specific system or integration is depicted.

Orchid Prevent surfaces issues for review. It does not code, alter, hold, or submit claims, and it does not send payer or provider queries.

From Review to Prevent

Turn review into prevention.

Orchid Review explains where recurring reimbursement issues appear after adjudication, why, and how much they matter. Orchid Prevent applies what Review has learned before the next claim reaches the payer.

  1. Learn from adjudication
  2. Confirm the pattern
  3. Move the control upstream

Orchid Review

Understand what happened and why.

Explore Orchid Review

Orchid Prevent

Flag issues before the next claim goes out.

Move one recurring issue upstream.

Talk through where the issue appears today and where Orchid Prevent could fit in the workflow before submission.

Talk through a pre-submission workflow

Orchid Prevent is designed to help teams address avoidable issues before submission. It does not guarantee payer acceptance, payment, or a reduction in denials.

Qualified people remain responsible for decisions and action. Orchid does not make autonomous billing decisions.