JSON twin: https://www.healthaidb.com/software/cofactor-ai-denials-suite.json
Cofactor AI
https://www.cofactorai.com/cofactor-ai-features
AI-driven platform that automates insurance denial appeals and DRG downgrade recovery for hospitals and health systems.
Cofactor AI Denials Suite integrates with EHRs to identify appealable denials, extract clinical and billing data, generate tailored appeal letters, prioritize cases by financial impact and likelihood of success, and track appeal outcomes; SOC 2 Type II and HIPAA compliant and available via integrations including Epic.
yes
2023
Flexible (cloud-hosted with options for hybrid or on-prem deployments); specific region options not published
P0370
2025-09-07
Commercial proprietary
Contact vendor for pricing, demo, and RFP; ROI calculator available on vendor site.
enterprise_quote
2023
Cloud-native; supports cloud, hybrid, or on-prem deployments; no public OS/DB hardware specs listed
product
1.0
{
"company_name": "Cofactor AI",
"company_url": "https://www.cofactorai.com/",
"company_offices": [
"United States"
],
"company_founding": "2023",
"product_url": "https://www.cofactorai.com/cofactor-ai-features",
"categories": [
"administrative",
"revenue cycle management",
"ai denials management",
"claims management",
"denials & appeals"
],
"market_segment": [
"enterprise",
"hospitals and health systems"
],
"links": [
"https://www.cofactorai.com/",
"https://www.cofactorai.com/cofactor-ai-features",
"https://www.cofactorai.com/cofactor-ai-security",
"https://www.cofactorai.com/cofactor-ai-about",
"https://www.cofactorai.com/roi",
"https://showroom.epic.com/Listing?id=2704&returnTitle=3",
"https://elion.health/products/cofactor-ai-denials-suite",
"https://www.globenewswire.com/news-release/2024/11/25/2986729/0/en/Cofactor-AI-Launches-Platform-to-Help-Hospitals-Fight-Tidal-Wave-of-Claims-Denials-and-Announces-4-Million-Seed-Round.html",
"https://fortune.com/2024/11/25/new-york-transform-tech-hub-kevin-ryan-david-tisch/",
"https://www.crunchbase.com/organization/catalyst-ai-888a"
],
"summary": "AI-driven platform that automates insurance denial appeals and DRG downgrade recovery for hospitals and health systems.",
"description": "Cofactor AI Denials Suite integrates with EHRs to identify appealable denials, extract clinical and billing data, generate tailored appeal letters, prioritize cases by financial impact and likelihood of success, and track appeal outcomes; SOC 2 Type II and HIPAA compliant and available via integrations including Epic.",
"target_users": [
"revenue cycle managers",
"denials management teams",
"health information management (HIM) teams",
"billing/coding specialists",
"hospital finance leaders",
"clinical documentation improvement (CDI) teams",
"RCM analysts",
"IT/integration teams"
],
"specialties": [
"Revenue cycle management",
"Health information management",
"Inpatient medicine",
"Hospital medicine",
"Clinical documentation improvement"
],
"regions_available": [
"United States"
],
"languages_supported": [
"English"
],
"pricing_model": "enterprise_quote",
"pricing_details": "Contact vendor for pricing, demo, and RFP; ROI calculator available on vendor site.",
"license": "Commercial proprietary",
"deployment_model": [
"cloud/SaaS",
"hybrid",
"on_prem"
],
"os_platforms": [
"Web"
],
"features": [
"Automated appeal letter generation",
"Payer-specific, fine-tuned responses",
"Root-cause analysis of denials",
"Payment and denial outcome prediction",
"Prioritization and ranking of denials by urgency/financial impact",
"Guided steps to correct and resubmit claims",
"Identification and categorization of payer-specific codes and info",
"Claims and medical record checks against coding and standard-of-care guidelines",
"Support for DRG and severity downgrade appeals",
"RAC audit appeals",
"Readmission and clinical necessity denial appeals",
"Retrospective review support",
"Workflow integration with RCM processes"
],
"optional_modules": [],
"integrations": [
"Epic",
"Cerner (Oracle Cerner)",
"Meditech",
"Athenahealth",
"Practice Fusion",
"eClinicalWorks",
"Availity (payers/clearinghouse)",
"Waystar",
"Experian",
"Quadax",
"Change",
"UnitedHealthcare",
"Aetna",
"Blue Cross Blue Shield",
"Clearinghouses / payer EDI connections"
],
"data_standards": [
"FHIR",
"HL7 v2",
"EDI",
"SFTP (secure file transfer)",
"OAuth2",
"TLS (1.2+)",
"AES-256 (encryption at rest)"
],
"api_available": "yes",
"system_requirements": "Cloud-native; supports cloud, hybrid, or on-prem deployments; no public OS/DB hardware specs listed",
"compliance": [
"HIPAA",
"HITECH",
"GDPR",
"SOC 2"
],
"certifications": [
"SOC 2"
],
"security_features": [
"AES-256 encryption at rest",
"TLS 1.2+ for data in transit",
"Role-based access control (RBAC)",
"OAuth2-based secure APIs",
"24/7 monitoring",
"Incident response policy"
],
"privacy_features": [
"HIPAA-compliant operations",
"Data de-identification / anonymization practices",
"Data minimization",
"Configurable data retention and secure deletion",
"BAA available"
],
"data_residency": "Flexible (cloud-hosted with options for hybrid or on-prem deployments); specific region options not published",
"customers": [],
"user_reviews": [],
"ratings": [],
"support_channels": [
"email",
"contact_form"
],
"training_options": [
"documentation"
],
"release_year": "2023",
"integration_partners": [
"Epic Systems",
"Oracle Cerner",
"Meditech",
"Payer systems",
"Clearinghouses"
],
"id": "P0370",
"slug": "cofactor-ai-denials-suite",
"type": "product",
"version": "1.0",
"last_updated": "2025-09-07",
"links_json": {
"self": "https://www.healthaidb.com/software/cofactor-ai-denials-suite.json"
}
}