Bulwark
Two Checks, One Either Side of the Payer
Before submission, Bulwark examines the claim, identifies denial risk and explains the problem so staff can fix it. After payment, it compares what the payer paid against what they should have paid and flags the difference.
A denial is a claim you already paid to produce
Every denied claim has already cost you the encounter, the documentation, the coding and the submission. Reworking it costs all of that again, and a meaningful share are never reworked at all.
Before submission, Bulwark examines the claim and identifies the risks that lead to denial, and explains what the problem is rather than emitting an error code. A staff member corrects it while correcting it is still cheap.
After payment, the second half of the job runs: expected payment is compared against actual payment, and potential underpayments are flagged for review. Underpayment is the quietest revenue loss there is, because the claim shows as paid.
Capabilities
What's included
Catch it before submission, and check it after payment
Pre-submission denial risk
Claims are examined for the patterns that precede denial, using your own historical denial data rather than a generic rule set.
Explained, not just flagged
The problem is described so staff can correct it, which is the difference between a useful check and an alert nobody reads.
Payment accuracy validation
Expected payment from your fee schedules is compared against what the payer actually remitted.
Underpayment flagging
Differences are surfaced for review, because a claim paid at the wrong rate still shows as paid on every report.
Why it matters
The outcomes practices actually measure
We are evaluated on the numbers that change in your operation, not on features shipped or tickets closed.
- Avoidable denials prevented
- The cheapest denial is the one that never happens, and most denials come from a small number of recurring causes.
- Less rework
- Rework is pure cost. Every claim corrected before submission is a rework cycle that never gets created.
- Incorrect payments found
- Payment at the wrong rate is invisible in standard reporting, which is exactly why it persists for years.
- Revenue protected on both sides
- One product covers the two moments where money is most often lost: before submission and after remittance.
How it works
What working with us looks like
- 1
Examine before submission
The assembled claim is examined and potential denial risks are identified ahead of submission.
- 2
Explain the risk
The potential problem is explained in terms a biller can act on, so the correction is obvious.
- 3
Staff correct and submit
A staff member verifies the issue and corrects the claim. Submission remains a human decision.
- 4
Validate the payment
After payment, expected and actual amounts are compared, and potential underpayments are flagged for review.
Frequently paired with
FAQ
Bulwark, frequently asked questions questions
- Does Bulwark submit or correct claims itself?
- No. It identifies and explains the risk. A staff member verifies the issue, corrects the claim and submits it.
- What does it need to work?
- Historical denial data for the prediction side, and current fee schedules for payment validation.
- Is this the same as claim scrubbing?
- Scrubbing checks a claim against fixed edits. Bulwark also looks at the patterns in your own denial history, and it continues working after the claim is paid, which scrubbing does not.
- What happens to a flagged underpayment?
- It goes to review. Where the payer has underpaid, Recourse handles the follow-up and, where appropriate, the appeal.
We're here to help
Ready to see what your revenue cycle could be doing?
Start wherever makes sense: a demo, a free assessment, or a straight conversation with someone who does this every day.