Healthcare Solutions
Real‑time problems we fix. How we fix them. What you get back.
Healthcare revenue, access, and data break in predictable ways. Claims deny. Prior auths stall. Lab results bottleneck. Portals don't talk. Staff get stretched, then good intentions turn into workarounds.
Why This Page Exists
Health Square exists to remove those bottlenecks on day one
We combine a decade of frontline experience with automation, analytics, and Artificial Intelligence so your team gets the same two gifts every day: time and cash collected.
Healthcare Challenges
What Healthcare Providers Are Up Against
Whether you run a clinic, lab, dental practice, or urgent care center, your biggest challenges usually sound like this:
“Why are my claims getting denied?”
“Where is the cash stuck in AR?”
“How do I keep up with payer changes and modifier rules?”
“Our coders are behind again.”
“I don't have time to train staff every time systems change.”
“I know we're leaving money on the table, but I can't prove it.”
Revenue Cycle Management (RCM) is no longer a back-office function. It's the financial engine of your healthcare organization and Health Square is here to supercharge it.
Real-time Solutions
What "real‑time" looks like
The problems we see every week and how we solve them immediately
Eligibility & Prior Authorization
Problem: Eligibility isn't checked correctly, benefits are mis‑read, COB not captured, and prior auths start late. Result: preventable denials. Solution: We hard‑gate appointments with automated eligibility (270/271), payer rule packs, and pre‑visit checklists. Our prior‑auth desk runs scripted queues with turn‑time SLAs and escalation paths.
Documentation & Coding Quality
Problem: Notes lack required elements, modifiers are missing (25, 59, XS/XU), or time‑based services aren't documented. Solution: We deploy documentation prompts inside your workflow and run post‑encounter QA. NLP models scan charts and flag missing elements before claim creation.
Claims Processing & Scrubbing
Problem: Rejections at the clearinghouse for formatting, demographics, NPI, taxonomy, place‑of‑service, CLIA and device IDs. Solution: Pre‑submission scrubber with payer‑specific edits, CLIA/ordering validation, NPI/taxonomy verification, and device ID libraries for diagnostics.
Denial Management & Appeals
Problem: No unified denial taxonomy, weak appeal packets, underpayment never found. Solution: Denials are normalized into a standard taxonomy (CARC/RARC → business reason). Appeals use auto‑built packets (clinical notes, auth, LCD). Underpayment engine compares allowed vs contract.
AR Management & Collections
Problem: AR aging with no pursuit logic. Follow‑ups happen by 'oldest first,' not 'highest collectability.' Solution: AR queues are scored by collectability (payer, balance, age, history, auth status). Staff work the highest‑yield queue first; everything is tracked to resolution.
Laboratory Operations
Problem: Lab throughput and downtime. Interface glitches, routing errors, manual result entry, and unclear downtime playbooks. Solution: Interface monitoring with auto‑retry, rules‑based routing, auto-verification for stable assays, downtime kits with recovery checklists.
Operating Model
How Health Square fixes it
Our systematic approach to transforming healthcare operations
Stabilize
Stop the bleeding: eligibility gate, auth desk, claim scrub rules, denial taxonomy.
Standardize
SOPs, templates, macros, routing tables, checklists.
Automate
RPA for portals, batch eligibility, ERA posting, underpayment detection, RPM minute capture.
Instrument
Dashboards, alerting, and daily control charts.
Optimize
Weekly Kaizen: remove waste, merge steps, shift work to the right team at the right time.
Govern
Scorecards for coders, AR reps, auth team; payer report cards; quarterly contract reviews.
Measurable Results
What you get back (measurables)
Proven results that impact your bottom line immediately
lift in first‑pass rate
denial reduction within 90 days
AR >90 reduction by month 6
RPM revenue in 60–90 days
Artificial Intelligence in Action
Artificial Intelligence in action (today)
Real Artificial Intelligence capabilities working in healthcare practices right now
Pre‑claim Prediction
Model scores claims for denial risk; high‑risk claims are fixed before submission.
NLP Doc Checks
Notes are scanned for required elements (time, exam, MDM, consent) and missing items are flagged.
Auth Autofill
OCR + RPA gathers clinicals and populates payer portals.
Lab Autoverification
Stable assays route straight to release when delta checks and QC rules pass.
Underpayment Detection
Artificial Intelligence highlights mismatches vs. contract terms for recovery.
RPM Minute Capture
Converts review actions and alerts into auditable time logs.
Specialty Coverage
Specialty coverage (how we tune the model)
Primary care, multi‑specialty, cardiology, ortho, pain, behavioral health, pediatrics, OBGYN, GI, uro, nephro, endocrinology, pulmonology, ID, oncology/hematology, radiology, pathology, urgent care, PT/OT, home health, dental/ortho, pharmacy services, ambulatory surgery centers.
Primary Care & Multi-Specialty
Comprehensive support for family medicine, internal medicine, and multi-specialty practices.
Cardiology & Critical Care
Specialized support for cardiology, pulmonology, and critical care specialties.
Behavioral Health & Neurology
Expert handling of behavioral health billing and neurology practice requirements.
Dental & Orthodontics
CDT code expertise and split-billing accuracy with PPOs for dental practices.
Surgical Specialties
Orthopedic surgery, general surgery, and ambulatory surgery center support.
Laboratory & Diagnostics
Pathology, radiology, and diagnostic laboratory billing and operations support.
For each specialty we adjust: documentation prompts, code sets, prior‑auth criteria, payer policy packs, and appeal templates.
Future Artificial Intelligence Roadmap
Artificial Intelligence next (roadmap)
Advanced Artificial Intelligence capabilities coming to healthcare operations
Denial reason generator
Drafts first‑pass appeal language with payer‑specific evidence.
Coding copilot
Real‑time CPT/ICD suggestions with LCD/NCD checks.
Capacity forecasting
Predicts staffing needs by payer mix, seasonality, clinic templates.
Anomaly watch
Detects sudden TAT spikes, device silences, interface slowdowns before they hit patients.
