Prevent the avoidable denial
Assess reimbursement risks and close coverage, authorization, and evidence gaps before the claim moves forward.
Explore IntelligenceFor revenue cycle teams
Fewer denials. Stronger reimbursement readiness.
Assess payment risk, prepare the evidence, and reduce repeated claim and authorization work. Give your team a clear next action before submission and after the payer responds.
Your revenue, in focusProduct tour
sehaXG / Revenue workspaceSynthetic demo
Denial intelligence
Find the reason. Focus the response.
- Denials grouped
- 74 Synthetic case sample
- Root causes
- 3 Shared reasons to review
- Open value
- BHD 15,110 Before payer decisions
Denials by root cause
Cluster insight
Authorization
Approved service scope requires confirmation.
Suggested ownerClinical reviewerReview common evidenceIllustrative product experience · No patient data
Synthetic product demo · No patient data or external actions.
IntelligenceAI agentsOrchestration
Built around your team
Make the next claim better prepared than the last.
sehaXG connects full-reimbursement estimates with coverage, readiness, and evidence checks. Use the reasons behind the risk to address preventable denial causes and underpayments, then give repetitive digital steps to agents.
Reduce repeated digital work
Use agents for coverage checks, digital submissions, status inquiries, and approved follow-up.
Explore AI AgentsAddress the payment shortfall
Bring denial reasons, payment differences, and supporting evidence into a coordinated response.
Explore OrchestrationA closer look
Powerful capabilities. Practical impact.
See the work, understand the opportunity, and turn the next best action into progress.
Eligibility & readiness
Prepare the claim with its coverage in view.
Review member eligibility, service and date context, authorization requirements, and supporting evidence before submission. Use the reasons behind the reimbursement estimate to identify what needs clarification, correction, or an additional document.
- Coverage and service checks
- Authorization and evidence gaps
- Explained risk and next actions
sehaXG / Revenue workspaceSynthetic demo
Coverage readiness
Know what to check before care.
Coverage check· XG-0248In review
sehaXG / Case workspace
Pre-service readinessVerify the details that matter.
Coverage on service date
Human review requiredCheck that the coverage applies to the planned service date.
Requirements
3 / 4Select a requirement to inspect the next check.
Carry the context forward
Resolve the missing detail once and keep it with the case for the next team.
Illustrative product experience · No patient data
Denials & appeals
Build the response around the reason.
Review the denial, gather the relevant approval and clinical material, and prepare the appeal or corrected claim. Track the filing context, review, submission, and available acknowledgement with the same case.
- Reason and supporting evidence
- Appeal and correction preparation
- Review, filing, and digital submission
sehaXG / Revenue workspaceSynthetic demo
Appeal preparation
Turn the evidence into a clear response.
Appeal draft· XG-0248In review
sehaXG / Case workspace
Evidence-backed responseA clearer case for review.
Denial reason
Human review requiredUse the payer’s reason to shape a relevant response.
Requirements
3 / 4Select a requirement to inspect the next check.
Keep the claim, reason and response together
One review package, with a traceable link to the supporting evidence.
Illustrative product experience · No patient data
Digital follow-up
Keep the status check from becoming another manual task.
Let agents check digital claim and appeal status, capture the response, and submit approved material. Bring a request for clarification or an unresolved exception to the team with the inquiry history ready.
- Digital status inquiries
- Approved requests and responses
- Context for human follow-up
sehaXG / Revenue workspaceSynthetic demo
AI agent activity
Digital follow-up, with a clear record.
sehaXG digital agentCase XG-0248 · Claim follow-up
Paused- 1Read the permitted case contextWithin the approved task scope
- 2Check the digital payer statusWithin the approved task scope
- 3Request review of the next actionHuman review before submission
- 4Submit the approved packageAuthorized digital channel
- 5Record the receipt and outcomeWithin the approved task scope
Activity record
01
Case scope verified
02
Preparing context
Submission requires approval
The reviewer sees the evidence and intended destination before the agent continues.
Illustrative product experience · No patient data
Payment integrity
Find the shortfall worth investigating.
Compare assessed payable amounts with receipts and documented adjustments. Separate a justified difference from a potential underpayment, attach the evidence, and use recurring findings to improve future claim preparation.
- Expected and actual payment context
- Adjustments and evidence review
- Justified recovery and prevention
sehaXG / Revenue workspaceSynthetic demo
Payment reconciliation
Make the payment difference visible.
Case XG-0248 · Payer AReview required
ExpectedBHD 480.000
ReceivedBHD 390.000
Difference to investigateBHD 90.000
Follow the payment calculation
Example- Submitted charge
- BHD 500.000
- Contractual adjustment
- − BHD 20.000
- Expected payer payment
- BHD 480.000
- Recorded remittance
- − BHD 390.000
- Unexplained difference
- BHD 90.000
Estimates depend on the applicable terms and evidence. The payer determines payment.
Illustrative product experience · No patient data
A little more clarity
Your questions,
answered.
How does sehaXG help before a claim is submitted?
It assesses reimbursement risk and checks the available coverage, authorization, and supporting evidence. The team sees the reasons and suggested corrections that can reduce preventable omissions before the next action.
Does an estimate of full reimbursement guarantee payment?
No. It is a decision-support estimate based on available information and relevant payment terms. Review the reasons and recommended actions; the actual payer decision determines the result.
Can the same workflow help reduce authorization rework?
Yes. Check readiness and evidence before an authorization request moves forward, assign missing inputs, and include the appropriate reviewer. This helps avoid repeated requests caused by preventable gaps.
Who handles a case that needs a conversation with the payer?
Your team handles phone conversations. sehaXG keeps the case context available while agents support the digital parts of follow-up.
Let’s move forward
Prepare for a better path to reimbursement.
Bring a recurring denial, payment gap, or incomplete authorization request. Explore the risk reasons, readiness checks, and actions that can help your team address it.
Request a demo