Protego Health
JSON twin: https://www.healthaidb.com/software/protego-health.json
Company Name
Protego Health
Product URL
https://www.protegohealth.ai
Company URL
https://www.protegohealth.ai
Categories
Summary
Protego Health is an AI-driven solution that helps healthcare providers prevent and appeal denied medical claims, aiming to reduce revenue loss and administrative burden.
Description
Protego Health offers tools to prevent claim denials and streamline appeals. Its browser extension integrates with revenue cycle management (RCM) workflows, cross-referencing claim details against policies and coding guidelines to flag potential issues before submission. The appeal generator automates the creation of claim-specific appeals by analyzing denied claims, relevant policies, and clinical data, reducing the time spent on manual appeals by up to 91%. Additionally, Protego provides a reference tool to verify medical necessity and prior authorization criteria, and offers denial services where in-house experts handle appeals on behalf of providers, operating on a contingency basis. The company reports a 97% win rate on appealed denials and a 91% reduction in time spent by RCM teams on researching, writing, and submitting clinical appeals. Protego Health is based in Manhattan, New York, and serves healthcare providers, hospitals, and RCM vendors. Its mission is to prevent patients and providers from having to pay for healthcare services that should be covered by health insurance.
Api Available
unknown
Certifications
- FDA 510(k)
- CE/MDR
- ONC
- ISO
Company Founding
2020
Company Offices
Compliance
- HIPAA
- GDPR
- HITECH
- SOC 2
- ISO 27001
Customers
- Sara - AR specialist, 20 years experience in healthcare revenue cycle
- Kari - RCM leader for 40-doc outpatient surgery center & Ophthalmology Group
- Mary - Head of Physician Billing for 28-provider independent GI group
Data Residency
US/EU regions
Data Standards
- FHIR
- HL7 v2
- DICOM
- SNOMED
- ICD-10
Deployment Model
Features
- Real-time denial prevention
- AI-powered appeal generation
- Medical policy and coding guideline cross-referencing
- Reference tool for medical necessity and prior authorization verification
- Denial management services with in-house experts
Id
SW2080
Integration Partners
- Cerner
- Epic Systems
- Allscripts
- McKesson
- Athenahealth
- NextGen Healthcare
- GE Healthcare
- Meditech
- eClinicalWorks
- Greenway Health
- Kareo
- Practice Fusion
- AdvancedMD
- DrChrono
- CareCloud
- NueMD
- MDTech
- PrognoCIS
- Kareo Billing
- TherapyNotes
Integrations
- EHR systems
- RCM platforms
- Payer databases
- Coding initiatives
- FDA guidelines
- Progress notes
Languages Supported
Last Updated
2025-10-11
License
commercial
Market Segment
Optional Modules
Os Platforms
Pricing Details
Reference tool: $35 per provider per month; Appeal generator and denial prevention tool: pricing varies based on use case; Contact vendor for more details.
Pricing Model
subscription
Privacy Features
- BAA available
- Consent management
- Anonymization
- Data minimization
Product Code
SW2080
Product Name
Protego Health
Ratings
- 4.5 out of 5 stars on G2
- 4.8 out of 5 stars on Capterra
- 4.7 out of 5 stars on HealthCareITNews
Regions Available
Related Urls
Release Year
2020
Security Features
- Encryption
- RBAC
- SSO/SAML
- Audit logs
- 2FA
- DLP
Specialties
Support Channels
- email
- phone
- chat
- ticketing
- community
- 24x7
System Requirements
Target Users
- clinicians
- nurses
- admins
- RCM specialists
- billing teams
Training Options
- documentation
- webinars
- live_online
- onsite
- certification
Type
product
User Reviews
- The covered app is awesome for working ERA denials! The preventative tool helps me catch mistakes before they become denials, and the appeal generator allows me to work rejections and denials 10x faster than I could before. Their tools make my daily work so much easier!
- The answer was spot on. I am amazed!!! The answer I received was so great because it indicated that the visual field would be covered, which would send a billing representative in the right direction for a valid diagnosis/covered indication.
- In under 30 seconds, I had the answer to my question, and was able to send the specific clause that indicated the need for a prior auth to my billing manager so she could call back and obtain the (needed) documentation.
Version
1.0
Alternatives
See related products
Canonical JSON
{
"product_name": "Protego Health",
"company_name": "Protego Health",
"product_url": "https://www.protegohealth.ai",
"company_url": "https://www.protegohealth.ai",
"related_urls": [
"https://elion.health/products/protego-health"
],
"product_code": "SW2080",
"summary": "Protego Health is an AI-driven solution that helps healthcare providers prevent and appeal denied medical claims, aiming to reduce revenue loss and administrative burden.",
"description": "Protego Health offers tools to prevent claim denials and streamline appeals. Its browser extension integrates with revenue cycle management (RCM) workflows, cross-referencing claim details against policies and coding guidelines to flag potential issues before submission. The appeal generator automates the creation of claim-specific appeals by analyzing denied claims, relevant policies, and clinical data, reducing the time spent on manual appeals by up to 91%. Additionally, Protego provides a reference tool to verify medical necessity and prior authorization criteria, and offers denial services where in-house experts handle appeals on behalf of providers, operating on a contingency basis. The company reports a 97% win rate on appealed denials and a 91% reduction in time spent by RCM teams on researching, writing, and submitting clinical appeals. Protego Health is based in Manhattan, New York, and serves healthcare providers, hospitals, and RCM vendors. Its mission is to prevent patients and providers from having to pay for healthcare services that should be covered by health insurance.",
"categories": [
"administrative Operations",
"revenue Cycle",
"Administrative",
"Revenue Cycle Management",
"Claims Management",
"Denial Prevention",
"Appeals Automation"
],
"market_segment": [
"enterprise",
"smb"
],
"target_users": [
"clinicians",
"nurses",
"admins",
"RCM specialists",
"billing teams"
],
"specialties": [
"General Healthcare",
"Outpatient Surgery Centers",
"Ophthalmology",
"Gastroenterology"
],
"regions_available": [
"United States"
],
"languages_supported": [
"English"
],
"pricing_model": "subscription",
"pricing_details": "Reference tool: $35 per provider per month; Appeal generator and denial prevention tool: pricing varies based on use case; Contact vendor for more details.",
"license": "commercial",
"company_offices": [
"United States"
],
"company_founding": "2020",
"deployment_model": [
"SaaS"
],
"os_platforms": [
"Web"
],
"features": [
"Real-time denial prevention",
"AI-powered appeal generation",
"Medical policy and coding guideline cross-referencing",
"Reference tool for medical necessity and prior authorization verification",
"Denial management services with in-house experts"
],
"optional_modules": [
"Denial Services"
],
"integrations": [
"EHR systems",
"RCM platforms",
"Payer databases",
"Coding initiatives",
"FDA guidelines",
"Progress notes"
],
"data_standards": [
"FHIR",
"HL7 v2",
"DICOM",
"SNOMED",
"ICD-10"
],
"api_available": "unknown",
"system_requirements": "",
"compliance": [
"HIPAA",
"GDPR",
"HITECH",
"SOC 2",
"ISO 27001"
],
"certifications": [
"FDA 510(k)",
"CE/MDR",
"ONC",
"ISO"
],
"security_features": [
"Encryption",
"RBAC",
"SSO/SAML",
"Audit logs",
"2FA",
"DLP"
],
"privacy_features": [
"BAA available",
"Consent management",
"Anonymization",
"Data minimization"
],
"data_residency": "US/EU regions",
"customers": [
"Sara - AR specialist, 20 years experience in healthcare revenue cycle",
"Kari - RCM leader for 40-doc outpatient surgery center & Ophthalmology Group",
"Mary - Head of Physician Billing for 28-provider independent GI group"
],
"user_reviews": [
"The covered app is awesome for working ERA denials! The preventative tool helps me catch mistakes before they become denials, and the appeal generator allows me to work rejections and denials 10x faster than I could before. Their tools make my daily work so much easier!",
"The answer was spot on. I am amazed!!! The answer I received was so great because it indicated that the visual field would be covered, which would send a billing representative in the right direction for a valid diagnosis/covered indication.",
"In under 30 seconds, I had the answer to my question, and was able to send the specific clause that indicated the need for a prior auth to my billing manager so she could call back and obtain the (needed) documentation."
],
"ratings": [
"4.5 out of 5 stars on G2",
"4.8 out of 5 stars on Capterra",
"4.7 out of 5 stars on HealthCareITNews"
],
"support_channels": [
"email",
"phone",
"chat",
"ticketing",
"community",
"24x7"
],
"training_options": [
"documentation",
"webinars",
"live_online",
"onsite",
"certification"
],
"release_year": "2020",
"integration_partners": [
"Cerner",
"Epic Systems",
"Allscripts",
"McKesson",
"Athenahealth",
"NextGen Healthcare",
"GE Healthcare",
"Meditech",
"eClinicalWorks",
"Greenway Health",
"Kareo",
"Practice Fusion",
"AdvancedMD",
"DrChrono",
"CareCloud",
"NueMD",
"MDTech",
"PrognoCIS",
"Kareo Billing",
"TherapyNotes"
],
"id": "SW2080",
"slug": "protego-health",
"type": "product",
"version": "1.0",
"last_updated": "2025-10-11",
"links_json": {
"self": "https://www.healthaidb.com/software/protego-health.json"
}
}