Detect Relevant Risk
Use connected clinical, administrative, claims, remittance, credentialing, and payer context to recognize conditions that require attention before a claim is submitted.
Embedded Clinical and Financial Decision Support
Embed Revenue Intelligence Into Upstream Workflows Before Risk Becomes a Denial
Decisive Connect brings client-governed intelligence to the clinical and administrative moments where reimbursement risk is created. The objective is not another downstream work queue. It is timely, evidence-backed support that helps the user resolve the issue at its source.
Point-of-workflowClient-governedEvidence-backedActionableAuditable
Embedded Revenue Workflows
See Intelligence Arrive at the Point of Action
Follow representative prior authorization, inpatient status, and telehealth scheduling workflows to see how users receive evidence and corrective guidance before the underlying risk becomes a denial.
Embedded Revenue Integrity
Workflow-aware intervention at the point of action
Clinical Order Entry
Diagnostic Imaging
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John Doe MRN 004685348
DOB 05/14/1968 · Example Health Plan · Member 88739402
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Decision Support Library
Explore Additional Workflow Examples
Explore representative clinical and administrative workflows. Select an example to see the evidence, intervention point, operational action, and revenue impact.
Scheduling and Credentialing
Catch provider credentialing issues at appointment creation and before the visit occurs.
Scheduling Workflow 1 of 2
Utilization Management
Surface admission-status and short-stay risks while the patient is still in care.
Utilization Management Workflow 1 of 2
Prior Authorization
Identify authorization, documentation, payer, and site-of-service requirements before service.
Prior Authorization Workflow 1 of 2
Our Strategy
Intelligence Becomes Valuable When It Changes the Workflow
Intervene at the Right Moment
Trigger support during ordering, scheduling, registration, authorization, admission, utilization review, documentation, or billing readiness while the underlying issue can still be resolved.
Explain and Enable Action
Present the patient- and workflow-specific evidence behind the intervention, then give the user an approved action, alternate path, or escalation workflow rather than an unexplained alert.
Govern and Improve
Version the decision logic, record every execution and response, measure outcomes, and refine client-approved workflows as payer behavior and operational needs change.
Flexible Delivery
Use the Integration Pattern the Workflow Supports
Native CDS Hooks are valuable where available, but healthcare workflows are heterogeneous. Decisive Connect uses standards-based and event-driven patterns to provide a consistent decision-support and governance model across modern and legacy applications.
Native CDS Hooks
Use standards-based CDS Hooks events where the source application supports them, returning contextually relevant cards and links at established workflow points.
Event-Driven Integration
Use FHIR APIs, HL7 v2 events, application APIs, database events, or other governed triggers when native CDS Hooks are not available.
Embedded and Connected Experiences
Deliver guidance through an embedded application panel, workflow notification, source-system link, work queue, or task action appropriate to the client’s environment.
Governance by Design
Platform Execution With Client-Controlled Decision Logic
Decisive Connect is designed as a configurable rules and workflow platform. Clients retain ownership of the clinical and operational decisions while the platform provides the integration, execution, evidence, security, and auditability needed to operationalize them.
Decisive Connect provides
- Integration and normalization of the required workflow context
- Reliable execution of approved rules and event triggers
- Evidence presentation, notification delivery, and action routing
- Configuration versioning, access control, and execution audit trails
- Technical monitoring, availability, and secure platform operation
The client governs
- Clinical and operational ownership of each decision-support use case
- Approval of criteria, inputs, thresholds, exclusions, and suppressions
- Approval of alert language, recommended actions, and escalation paths
- Validation within the client’s patient population and operating environment
- Ongoing governance, performance review, and authorization of changes
Clinical use cases require use-case-specific governance.
A configured workflow’s regulatory posture depends on what it does and how its output is used. Clinical validation, intended-use review, and regulatory assessment should be completed before deploying time-critical prediction, diagnosis, or treatment-related functionality.
Identify the Right Embedded Workflow
We work with revenue integrity, clinical, operational, and technology leaders to identify high-value intervention points and define a governed path from evidence to action.
Discuss an embedded CDS workflow