Cedar Point finds the preventable denials — the ones tied to NC Medicaid billing rules, federal Medicare regulation, and TRICARE East policy — and shows you exactly which claims, why, and how much. You only pay when we're right.
Your billing team exports the denial or claims report they already have — nothing new to build, nothing to integrate with your EHR on day one.
Every rule in our engine is traced to a real source — the current NC Medicaid billing guide, 42 CFR 424.44, TRICARE East policy — not a guess at what might be wrong.
A dashboard shows exactly which claims were flagged, the specific rule they broke, and the dollar amount — ready for your billing team to act on.
A rough, methodology-consistent estimate — not a promise. Enter your hospital's approximate annual patient revenue.
Based on the same recoverable-leakage assumptions Cedar Point uses in real hospital estimates: a conservative-to-strong range depending on how much of your denial volume is mechanical and preventable (formatting, coding, routing errors) versus requiring deeper intervention. Real numbers only come from your actual claims data.
This is the difference between a generic claims scrubber and something built specifically for North Carolina hospitals.
NDC codes must be in 11-digit 5-4-2 format for NC Medicaid managed care claims — a mechanical, fully preventable denial category.
Behavioral health claims billed to a standard health plan instead of the correct Tailored Plan get denied — a routing error, not a clinical one.
Claims filed more than 365 days after date of service are automatically denied, with no appeal rights — a deadline, not a judgment call.
The same 365-day filing rule applies to TRICARE claims — relevant to any hospital near a military installation with a meaningful TRICARE patient population.
Cedar Point is paid a percentage of recovered funds — not a subscription, not a setup fee.
A signed Business Associate Agreement comes before any real claims data ever moves.
Not a national platform retrofit for NC — this was built around North Carolina's rules first.
A short conversation, no obligation — we'll walk through what Cedar Point would look for in your billing.
hello@cedarpointpro.com