Sentinel
The right status, before admission.
Sentinel screens a patient's level of care before the admission status is set — transparent, criteria-traced utilization-management screening anchored in CMS's Two-Midnight Rule, with a licensed clinician making every determination.
What it does
Medical-necessity and level-of-care denials are decided at the door — long before a claim exists. Sentinel screens admissions, continued stays, and discharge readiness against a physician-governed criteria library, with CMS's Two-Midnight Rule as the Medicare backbone and the Inpatient-Only list applied automatically. Every recommendation carries its full criteria trace — never a bare verdict — and anything uncertain routes to a physician advisor. Sentinel screens; your licensed clinicians decide.
Capabilities
- Admission, continued-stay, and discharge-readiness screening
- Two-Midnight Rule (42 CFR 412.3) overlay with the CMS Inpatient-Only list
- Full criteria trace on every recommendation — transparent, auditable logic
- Physician-advisor governance — criteria are inactive until a physician signs off
- CMS NCD/LCD coverage references with a refreshable content pipeline
How it works
Screen
Each review runs a severity-of-illness / intensity-of-service rollup with the Two-Midnight payment overlay and the CMS Inpatient-Only shortcut — before the status is set.
Trace
Every recommendation ships with the exact criteria it relied on. Uncertain cases route to secondary review by a physician advisor — nothing auto-denies, ever.
Decide
A licensed clinician makes the determination and records it in your UR system of record; Sentinel keeps de-identified metrics and a tamper-evident governance ledger.
Why it matters
A level-of-care denial voids an entire stay's reimbursement, and status changed after discharge is revenue you rarely recover. Screening at the door — with logic your physicians approved and can inspect — prevents the denial instead of litigating it, and keeps every determination in licensed human hands.
Security & compliance
Sentinel is built PHI-free by design — clinical inputs are evaluated in memory and never persisted; only de-identified metrics and a hash-chained audit and governance ledger are stored. It operates as transparent, non-device clinical decision support: it recommends with a criteria trace, and a licensed clinician owns every determination. Every Paladyn tool is built toward HITRUST and SOC 2.
Explore related tools
See where prevention pays off.
Request a revenue cycle assessment and we'll show how Paladyn would apply to your denials, AR, and payer mix.
Request an assessment