Strengthen claim defensibility before submission.
Orchid Prevent brings payer-aware evidence into the pre-submission workflow so RCM teams can identify avoidable claim issues while there is still time to act.
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.
After submission
- Claim submitted
- Payer response
- Investigation
- Rework
Before submission
- Claim ready
- Orchid Prevent
- Review where needed
- 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 a defensibility issue?
Put defensibility in the workflow.
Orchid Prevent sits before submission, showing what deserves attention and why while your team keeps the final decision.
Your workflow
Existing claim workflow
The systems your team already runs.
The moment
Draft claim ready
Assembled, not yet submitted.
Orchid
Orchid Prevent
An evidence-backed decision layer before submission.
- Appears supported
- Needs attention
- Uncertain
Your team
Qualified human action
A person decides what happens next.
- Continue
- Review
- Resolve issue
- Route for review
Your workflow
Existing submission workflow
Submission remains in the system your team already uses.
Inside the Orchid Prevent layer
- Claim context + available evidence
- Defensibility review
- Reason for attention
- Human decision
Orchid Prevent surfaces issues for review. It does not code, alter, hold, or submit claims, and it does not send payer or provider queries.
Turn review into prevention.
Orchid Review shows where recurring reimbursement and defensibility issues appear after adjudication. Orchid Prevent moves sufficiently understood patterns upstream, before the next claim reaches the payer.
- Learn from adjudication
- Confirm the pattern
- Move the control upstream
Orchid Prevent
Address it before submission.
Move one recurring issue upstream.
Talk through where the issue appears today and where Orchid Prevent could fit in the workflow before submission.
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.