Protego Health is a platform that automates the process of preventing and, when necessary, appealing denied medical claims for healthcare providers. By cross-referencing payer policies, billing/coding guidelines, and medical records, it can utilize AI to identify problems before them become denials, rectify denials, and generate appeal letters.

Our single platform approach provides immediate visibility into revenue cycle opportunities, tackling some of today's biggest challenges with the following Productized Analytics Suite Modules:

• Workforce Quality Insights (WQI) – Links front-office actions to financial KPIs
• Patient Access Insights (PAI) – Enhances financial experience pre-service
• Revenue Integrity Suite (RI) – Reduces denials and compliance risks
• Productivity Analytics (PA) – Improves staff productivity in real-time
• Cost Insights (CI) – Targets controllable costs
• Business Office Suite (BOS) – Unifies patient accounting data

Founded in 1993, MedeAnalytics is an innovation-focused company. Over the past three decades, we have worked tirelessly to reimagine healthcare through the power of data—and helped thousands of organizations achieve their potential along the way.

Leveraging state-of-the-art analytics and data activation, MedeAnalytics delivers actionable insights that support payers, providers, employers, and public entities as they navigate the complex healthcare landscape.

Using artificial intelligence and machine learning alongside the most advanced data orchestration in the industry, we empower organizations to optimize their resource allocation, experience superior patient outcomes, and achieve population health management goals.

Prevention and Appeal in the same engine: Protego's intelligencs pulls together billing/coding guidelines and specific payer policies. Using that technology, we can prevent denials at the point of claim creation by reading claim inputs in real time, running them against those rules, and flagging potential errors. On the back end, since some denials are inevitable, we can automate the appeals using that same intelligence engine. 

Incumbent RCM software companies: Move slowly, denials not a core focus area, and with older solutions, the tech is not easy to use or modernize. Our sole focus is excellence in the prevention and addressing of denials. 

New Entrants / Direct Competitors: Very new, and in a fragmented physician market, there are billions of dollars in denials to attack. Our focus is on the truth. What does the payer say they will cover, and how does that match up to what was done?

• Detailed and summary level reporting for different views to serve multiple purposes; 
• Standard and ad-hoc reporting allowing clients flexibility to slice/dice based on unique corporate needs;
• Incorporation of MedeAchieve across entire RCM portfolio to incorporate metric tracking into key enterprise initiative tracking;
• Worklisting available throughout the RCM workflow;
• Vendor flexibility – Plug & play any vendor into existing Mede workflows;
• Robust rules engine to drive efficiencies and streamline workflows;
• Integration of AI Agents to streamline and reduce manual entry;
• Predictive analytics using AI intelligence;
• Focus on productivity analytics to highlight and stratify registrar performance;
• Integrated Financial Clearance Workflows to maximize revenue generation

Enterprise Analytics - MedeAnalytics helps users identify key outliers in their data and distribute the right actionable information to the right people – at the right level – throughout the enterprise. 

MedeAnalytics can measure revenue and practice performance across the entire system. Our approach to organizing data into a patient longitudinal record has led to improved financial, operational, and even clinical performance.

Our Integrated MedeAchieve solution improves strategy execution with action plans that define your objectives, align staff around shared goals, and track progress in a closed­ loop system.