Deliver care
not admin
End-to-end RCM & prior-auth automation for specialty clinics.
Full benefits and payer policy checks for clean PAs, claims, and remittances.
Aetna · PPOcoverage lapsedLapsed 03/31/26
UnitedHealthcare · Choice Plusfound by insurance discovery — set primaryActive
Stop managing fragmented black boxes.
Foresight orchestrates everything from eligibility and prior auths to claims and denials, with optional managed services.
PAs and claims built to meet payer criteria for medical necessity and reimbursement.
Recurring denials and underpayments flagged for investigation and follow-up.
Clean submissions
Your payer rules
We configure and refresh requirements and exceptions by payer, provider, service, location. Each decision records the rule or source behind it.
Benefits verified
Benefit responses reconciled across sources, with TPA carve-outs identified and conflicting information resolved.
Smart submissions
Payer-specific edits and routine corrections applied before submission. Unresolved claims arrive with the reason and proposed fix.
Safe, auditable automation
Every field shows its source: a record, a rule, an automated investigation. All answers are backed by evidence for review.
Medical necessity checked from intake
- We apply the policy for that service. Coverage criteria and required documentation are checked against the plan at intake and again before submission.
- See all supporting evidence. Each finding links to the chart and source policy.
- Flagged unanswered questions for the treating team.
The plan won’t pay this visit without its Medi-Cal Social Services & Mental Health Referral Form.
Routine fixes automated. Exceptions flagged.
Fragmented RCM has a price.
Put your team’s time where it matters.
Tired of clicking? Just ask
- Answers use current claims, PAs, and denials without waiting for an export.
- Follow-ups refine the answer: “Break that down by payer.”
- Read-only access: answers do not change claims, PAs, or work items.
- Your data stays yours. We don't train on it, and every look up is logged.
From the start, to high-volume care.
Built around your specialty.
Coverage depends on the documented indication and the patient's plan. Initial requests and renewals need different evidence.
Frequently asked.
01Can we keep our EHR and billing team?
Yes. Foresight works with your existing EHR and writes results back. Your team can handle exceptions, or you can add managed services for follow-up and billing work. We agree which workflows and responsibilities move to Foresight during scoping.
02What requires clinician review?
Every PA packet, including a resubmission, requires clinician review and sign-off. AI drafts answers and gathers supporting evidence; it does not approve treatment.
For claims, you set the confidence thresholds for automatic submission. Missing evidence, uncertain coding, and unresolved payer requirements go to your team.
03What does Foresight check beyond claim format?
Foresight checks whether the clinical note supports the diagnosis and service, whether required fields agree, and whether the record meets the payer’s documentation criteria. Each finding includes its source and proposed next action.
04How do we evaluate fit?
We map your SOP and analyze de-identified samples: denied claims, stuck PAs, or your top denial reasons. In a live 30-minute session, we show what Foresight would prevent, fix automatically, and recover. No commitment; we will tell you if we do not find substantial recovery potential.
Tell us what's hurting.
We'll identify what can be automated and which decisions should stay with your clinical and billing teams.
What we'll review together
- 01Claim / PA volume
- 02Denial rates and reasons
- 03Eligibility issues
- 04A/R buckets
- 05Budget and priorities