Platform
One operations layerfor all of healthcare.
Connectivity, policy intelligence, automation, and human-in-the-loop review, designed to be explainable, auditable, and safe by default.
Most tools automate a task.We designed the whole cycle.
Context is never lost between steps. What eligibility learns, authorization uses. What authorization approves, the claim carries. What the claim reveals, the front end fixes.
Eligibility & benefits
Know coverage before the visit is scheduled.
Real-time 270/271 checks plus payer-portal intelligence surface active coverage, plan rules, and patient responsibility in seconds.
- Continuous re-verification ahead of the date of service
- Plan-level benefit interpretation and cost estimates
- Coordination-of-benefits detection
- Check coverage270/271 · 0.8sCompleted
- Interpret benefitsAetna PPOCompleted
- Estimate responsibility$40 copay · 82% deductible metCompleted
Prior authorization
Touchless submissions for high-volume specialties.
Policy intelligence determines whether an auth is required, assembles the clinical package from the chart, submits through the fastest payer channel, and tracks status to decision.
- Auth-requirement determination against live payer policy
- Clinical documentation bundling from the EHR
- Automated status polling and post-auth monitoring
Ready to submit
Infliximab infusion · J1745
- Drug
- Infliximab, J1745
- Payer
- BCBS · Medical Policy 2.04
- Documents
- 2 notes, 1 lab panel
- Channel
- Payer portal · automated
Claims & denials
Clean claims out. Denials prevented, not just worked.
Pre-submission scrubbing catches coding and coverage mismatches before they become denials, while root-cause analytics tell you exactly what to fix upstream.
- CPT and diagnosis mismatch detection against the auth on file
- Payer-specific edit libraries kept current automatically
- Denial root-cause clustering and appeal drafting
- Scrub claim 4471-04UHC · 837PCompleted
- Match auth on file#A82-114Completed
- 3CPT 27447 vs. auth 27446flagged pre-submitNeeds review
Operations intelligence
See the whole cycle. Act on what matters.
Payer scorecards, staff productivity, and predictive alerts across eligibility, authorization, and claims, before revenue is at risk.
- Payer turnaround and approval-rate benchmarking
- Work-queue health and staffing forecasts
- Complete audit trail on every automated action
Payer scorecard · last 30 days
- Aetna96%
- BCBS93%
- UHC91%
- Cigna94%
Approval rateAvg turnaround 1.4 d
Architecture
Plugs into the systems you already run.
Standards-based connectivity in, decision-ready work out. No rip-and-replace, no new portal for staff to learn.
Sources
- Epic, Oracle Health, athenahealth
- Availity, Waystar, Change
- Payer portals
- FHIR R4 · X12 270/271 · 278 · 837/835
Platform
- Connectivity layer
- Policy intelligence
- Automation and intelligent review
- Human-in-the-loop
Outcomes
- Touchless authorizations
- Clean claims
- Faster payer decisions
- Explainable audit trail
99.95%
Platform availability SLA
< 200ms
p95 API response time
0
PHI in model training
100%
Actions auditable
Security & compliance
Enterprise-grade by default.
Protected health information never leaves controlled, encrypted infrastructure. Every automated action is logged, attributable, and reversible.
- HIPAA
- SOC 2 Type II
- HITRUST-aligned
- BAA available
Encryption everywhere
AES-256 at rest, TLS 1.3 in transit, customer-managed keys available.
Least-privilege access
SSO/SAML, SCIM provisioning, role-based permissions, just-in-time elevation.
Complete audit trail
Immutable logs for every read, write, and automated decision.
Model governance
Outputs are explainable, monitored for drift, and gated by confidence thresholds.
Ready to empower your operations?
Bring your toughest payer, your busiest team, and thirty minutes. We will show you what touchless looks like on your own workflows.