01 / Ingest
Pull in your contracts and your claims.
Payer contracts, fee schedules, prior-auth rules, your 835s and 837s, plus the denial history sitting in your RCM. We work with what you have, Epic, Cerner, Athena, Meditech, NextGen. SFTP or secure object storage.
Payer contractsFee schedules835 / 837Denial history
02 / Forensic Audit
Re-read every paid & denied claim against the contract.
ZOE applies the codified contract logic to your historical adjudications. Underpayments, soft denials your team wrote off, missed timely-filing wins, missed clinical-policy arguments, surfaced with the dollar delta and the contract clause.
UnderpaymentsWrite-off recoveryCARC reattribution
03 / Recover
Build the appeal. Submit. Get paid.
Every recoverable claim is packaged with a payer-specific appeal letter, the exact contract clause, the clinical evidence, and the precise dollar argument. Your team approves, ZOE submits, or hands off to your appeals team.
Appeal-ready packsPayer-specific routingStatus tracking
04 / Prevent
Catch the next leak at the front door.
ZOE's forward-looking layer reads your charge capture and pre-bill claims, flagging the patterns most likely to be denied or underpaid, before they leave your facility. Less write-off. More clean claims.
Pre-bill flagsCharge-capture reviewDenial pattern analysis