Sun Tzu
Prevent denials before they happen.
Sun Tzu is Paladyn's denial-prevention engine. It reads every claim before it leaves the building, flags the ones a payer's rules would deny, and surfaces the root cause so it can be fixed pre-bill, not chased weeks later.
What it does
Most revenue cycle teams react: a claim denies, someone works it, the money trickles back later. Sun Tzu inverts that. It checks each claim against the payer's own rules and your denial history, routes the risky ones for correction first, and drafts technical, clinical, and coding appeals for the few that still slip through. Every flag is traceable to the rule that fired (no black box) and every denial that comes back becomes a new pre-bill check, so the same denial doesn't happen twice.
Capabilities
- Pre-bill claim review with rule-based risk scoring
- Automated technical, clinical, and coding appeals
- AR follow-up work queue and collections co-pilot
- Underpayment detection and appeals
- Root-cause feedback that prevents repeat denials
How it works
Ingest
Claims and remittances flow in over a secure SFTP feed (837 out, 835 back) and are parsed into one canonical model.
Check & flag
Every claim is checked against payer rules before it's submitted, and the root cause is surfaced so it can be fixed pre-bill.
Fix & prevent
Issues are corrected before submission; the root cause becomes a new pre-bill check so the denial doesn't repeat, and any true denial routes to automated appeals.
Why it matters
Roughly one in nine claims is denied on first submission, and most denials are preventable. Preventing a denial costs a fraction of appealing one, and protects revenue that would otherwise be written off.
Security & compliance
Sun Tzu runs inside Paladyn's HIPAA-aligned AWS environment; protected health information is processed only through secure, contracted channels with a tamper-evident audit trail. Every Paladyn tool is built toward HITRUST and SOC 2, with PHI controlled per our standards and a tamper-evident audit trail.
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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.
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