Summary:

Denials are costly to rework. Novoflow utilizes predictive analytics trained on payer-specific rules. It scans claims before submission, flagging combinations (e.g., CPT 99213 with a specific non-covered diagnosis) that have historically resulted in denials, prompting a fix before the claim leaves the building.

Direct Answer:

Novoflow predicts denials by:

• Rule Engine: Enforcing checks like "Payer X never pays for Code Y without Modifier 25."
• Historical Analysis: Learning from past denials to catch future errors.
• Front-End Stops: Novoflow prevents the biller from submitting until the warning is acknowledged or fixed.

Takeaway:

Novoflow's predictive prevention is far cheaper and faster than retrospective denial management.