ON DUTY 24×7
Denial Guard
The claims fighter
Classifies why a claim was denied and drafts the appeal, within value and review thresholds you set.
SCOPE OF PRACTICE
Drafts the appeal. A biller files it.
reports to: your staffView agent →
MedOrbit for billing executives
Build the discharge bill from posted charges, file NHCX/PMJAY claims, work the AI denial queue instead of a spreadsheet.
Their day, before and after
The same shift — what changes when MedOrbit runs it.
Today, without MedOrbit
- Building the discharge bill from charge slips collected around the ward.
- Filing an NHCX or PM-JAY claim through a system separate from the bill.
- Working denials from a spreadsheet, in whatever order they arrived.
- Re-explaining the same denial reason to a doctor every time it recurs.
With MedOrbit
- Builds the discharge bill from charges already posted to the account.
- Files NHCX and PM-JAY claims from the same billing workspace.
- Works a denial workqueue instead of a spreadsheet, appeal already drafted and cited.
- Reviews and files each drafted appeal instead of writing one from scratch.
Where they live
The parts of the platform this role opens every day.
Agents that report to them
Two of the 11 built-in agents do their best work here — every action human-approved.
Questions billing executives ask us
Can Denial Guard file an appeal without me?
No. Every draft appeal waits for a biller's review, and claims above a set threshold get a senior reviewer too.
Does the denial workqueue replace our NHCX/PM-JAY claim filing?
No — it sits alongside it. Claims still file through the same billing workspace; the workqueue is where a bounced claim's decoded reason and drafted appeal wait for you.
Where does the discharge bill's data come from?
From charges already posted to the account during the stay, not a manual reconstruction at discharge.