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.

• Send 837P, 837I, and 837D claims to 2,700+ payers.
• Improve acceptance rates with automated claim edits.
• Streamlined transaction enrollment, including one-click enrollment for 850+ payers.
• Programmatically upload and send 275 claim attachments.
• Check claim status in real time using 276/277.
• Automatically track 277 claim acknowledgments and 835 ERA responses with webhooks.
• Generate CMS-1500 PDFs on demand.

Stedi is the only clearinghouse built on modern APIs, while supporting both real-time and batch EDI processes.

Stedi enables health techs and incumbents to exchange mission-critical transactions - from eligibility to claims and remits. With a security-first cloud infrastructure, built-in payer redundancy via 3,500+ route connections, and market-leading sub-10-minute support response times, Stedi provides reliability and responsiveness to avoid billing outages and reduce denials.

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?

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• Connects to 3,500+ payers – the broadest coverage of any clearinghouse.
• Modern, JSON-based APIs.
• Streamlined "do-it-for-your" transaction enrollment for 835 Electronic Remittance Advice (ERA) responses.