Platform
The full DataHub platform.
Every part of the claims workflow in detail: Falcon AI, the Re-Sub workspace, coding checks and revenue analytics.
Falcon AI
Falcon AI advises. Your team decides.
1. Your rules
Contract terms, coverage and payer rules are set once.
2. Check
Every claim is checked against your rules and UAE code sets.
3. Score
Claims are ranked by denial risk, with the reasons shown.
4. Recommend
A plain-language fix and the rule behind it.
5. You decide
Nothing is sent without your team’s approval.
Example
- Claim
- CLM-20931
- Denial risk
- prior approval missing
- Fix
- attach the approval and resubmit as a correction
- Rule
- payer contract, section 7.3
DataHub Falcon
Why was CLM-20931 denied?
The claim was denied because prior authorisation was required but was not attached. The required prior authorisation documentation was not included with the claim.
Recommended next step: verify the authorisation (EA0055415077), attach the required documentation and follow the payer's correction or resubmission process.
Source: payer contract, section 7.3, version active on the date of service. Estimates support decisions; they are not guarantees of payer outcomes.
Demonstration using synthetic sample data.
Where it happens · Claims Resubmission Workspace
One Workspace for Denial Recovery
Every denied claim lands in one place. Correct it, attach proof, comment and upload without leaving the screen.
Rework any module inline
Metadata, patient, encounter, diagnosis, activities and resubmission details each open as an editable module — correct the specific fields identified in the denial.
Attach documents and explain the change
Add supporting documents and a note to each claim, so the reason for every correction travels with it.
Edit activities and add observations
Fix codes, quantities and amounts in the activity grid, and add the observations payers ask for — right in the row.
Correct, reconcile or write off — then upload
Pick the right action per claim and push to test or production. The same flow handles whole batches.
Clear claim ownership
Claim locks, assignment, comments and attachments keep your team working on the same version.
First-Pass Claim Accuracy
ICD-10, CPT and drug codes, observations and prior approvals are checked before the claim reaches the payer.
- ICD-10-CM, CPT/HCPCS and drug-code checks
- Missing observations, documents and authorisations
- Coverage, eligibility and contract-date rules
ACTIVITIES
Add Service or Activity| ID | TYPE | CODE | QTY | NET | ACTIONS |
|---|---|---|---|---|---|
| 1 | ICD-10 | R51.9X | 1.00 | 0.00 | + Required Observation |
| 2 | CPT | 96372 | 1.00 | 0.00 | + Required Observation |
| 3 | Drug | 0095-1499-11 | 1.00 | 0.43 | + Required Observation |
Validation found issues:
- R51.9X is not a valid ICD-10-CM code. Suggested: R51.9 (check against the clinical notes).
- Missing required observation or supporting documentation for activity 2 (CPT 96372).
Review flagged issues alongside the claim and resolve them before submission. Sample data.
Visual dashboards
Know where your revenue stands.
Monitor billed, paid, rejected and pending claims across facilities, payers and reporting periods.
- See your top initial denial codes and where denials concentrate
- Identify payment delays and days in receivables
- Open any claim's full activity history, from submission to payment, based on each user's access
- Monitor trends using the latest successfully processed data, refreshed after each nightly data load
Detailed reports
Every claim. Every payment. Full visibility.
Give finance and RCM teams actionable claim-level and payment-level reporting.
- Analyse submissions, rejections, resubmissions and remittances
- Track ageing balances and outstanding claims
- Allocate remittance payments to each claim and flag unallocated amounts
- Export filtered reports in supported formats
Ready to see it on your own claims?
Schedule a Time