Milagro, a leading provider of AI-powered healthcare revenue cycle solutions, announced the launch of two products: CodeGuard and ClaimGuard.
These solutions tackle some of the most persistent and costly issues in surgical revenue cycle management. This launch makes Milagro’s technology available as two distinct offerings, built to give hospitals flexibility and clarity in addressing surgical revenue cycle challenges.
CodeGuard: Autonomous Surgical Coding
CodeGuard is the industry’s only proven platform to accurately and autonomously code even the most complex surgical cases across all outpatient surgery specialties. Powered by advanced AI and clinical logic, CodeGuard interprets and codes procedures in real time, eliminating bottlenecks, minimizing reimbursement delays, and ensuring exceptional accuracy at scale.
With seamless EHR integration and fully auditable coding transparency, CodeGuard helps healthcare organizations accelerate reimbursement, reduce costs, and maintain efficiency across all surgical specialties.
Key benefits of CodeGuard include:
- Coding turnaround reduced from days to minutes
- Lower staffing costs and reduced reliance on hard-to-hire coders
- Higher accuracy than human coders preventing down-coding and accuracy-based denials
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ClaimGuard: Real-Time Pre-Authorization Denial Prevention
ClaimGuard helps prevent up to 95% of pre-authorization mismatch denials – a leading cause of lost surgical revenue. Leveraging real-time AI, ClaimGuard detects immediately post-op, procedures that deviated from what was pre-authorized, and based on its built-in payer-specific intelligence – determines which of these cases are eligible for and require re-authorization in order to get paid. ClaimGuard protects revenue and reduces write-offs without disrupting existing systems.
Key benefits of ClaimGuard include:
- Up to 95% reduction in pre-authorization mismatch denials
- Nearly $4M in recovered revenue per 10,000 surgeries
- EHR-agnostic implementation, including support for Epic
- Complements CodeGuard or functions as a stand-alone denial prevention solution
Meeting Hospitals Where They Are
“At Milagro, we believe hospitals deserve solutions that are both practical and powerful,” said Amit May Dan, CEO & Co-founder of Milagro. “CodeGuard and ClaimGuard were built to address the real-world challenges our clients face daily – delivering accuracy, speed, and confidence in the most critical parts of the surgical revenue cycle.”
SOURCE: PRNewswire