Axora agents retrieve real-time payer intelligence, evaluate claim context holistically, and surface risks before submission, not after rejection
Retrieves current payer guidance, contract logic, and adjudication signals using RAG-grounded intelligence
Agents evaluate documentation context, coding logic, and payer rules together as a coordinated decision
Submission risks are surfaced and routed for correction before the claim moves forward
Unlike traditional claim scrubbers that validate fields against static rule libraries, Codora evaluates the full claim context and surfaces submission risks earlier in the workflow.
Codora evaluates whether a claim will clear payer scrutiny before submission by analyzing documentation context, coding relationships, payer requirements, and adjudication behavior together.
Visit caps, exclusions, plan logic, mapped instantly
Mid-cycle rule shifts flagged in real time
Live prompts ensure cleaner, accurate front-office capture
Actionable signals and correction paths that surface inside the workflow — not buried in reports or dashboards
Eligibility & Benefits Intelligence
Payer Rule Intelligence
Documentation & Coding Alignment
Pattern Recognition & Drift Alerts
A 200-bed hospital kept seeing “coverage terminated” despite clean checks
Axora detected a mid-cycle shift in payer files and alerted the front office instantly
Coverage-related denials dropped within 30 days
A rehab centre scheduled sessions beyond the patient’s visit limits
Axora surfaced benefit-cap risks at the moment of scheduling
No denials for exceeded limits going forward
A multi-specialty hospital kept seeing “auth approved but benefit denied”
Axora matched auth rules with live benefit logic and flagged the mismatch early
The recurring denial loop stopped within two cycles
A diagnostics network faced denials for high-risk CPT × diagnosis combinations
Axora predicted these conflicts before verification ran
Claims were corrected upfront, avoiding downstream fallout