Work more claims with your existing team.
Add payer-policy checks to your clients’ existing systems. Uncertain cases route to your queue, bots, or the client’s system so your team can focus on exceptions.
Foresight API
One API for the entire revenue cycle.
Build revenue-cycle features with a REST API, signed webhooks, and an exception queue — without hiring a billing department or writing X12 by hand.
150+ endpointsHMAC-signed webhooksFirst request in minutesSandbox on request
foresight · apiX-Environment: sandbox
{
"status": "active",
"networkStatus": "in_network",
"coordinationOfBenefits": [
{ "rank": "primary", "payer": "uhc" },
{ "rank": "secondary", "payer": "medicaid_tx" }
],
"carveOut": { "detected": true, "entity": "behavioral_health" },
"patientResponsibility": { "low": 145.00, "high": 205.00, "confidence": 2 }
}
synthetic data
Eligibility, prior auth, and claim checks in practice.
Multi-source eligibility. One call checks more than one clearinghouse, catches carve-outs, runs coordination of benefit checks, fixes missing / incorrect data, checks co-pay brackets, and returns a confidence-scored answer.
Prior auth from the chart. The packet assembles itself, medical necessity is scored against the payer’s own policy, and the letter is drafted — a clinician signs off before anything goes out.
Scrubbing with citations. Every warning names the payer rule it came from — source, effective month, and the fix, auto-applied when it’s safe.
Webhooks close the loop. Lifecycle events land in your system signed and retried, so you never poll for a status.
Built to sit behind your product.
RCM firms, scribe platforms, EHRs, and point solutions run on the same API — under their own brand, inside their own workflow.
Submit claims from the documented encounter.
Turn your notes and codes into claims scrubbed against payer policy, submitted, tracked, and posted under your brand.
Add billing to your clinical workflow.
Embed eligibility, claims, denials, statements, and payment posting behind your own UI. Foresight watches encounter events, runs the billing work, and writes results back — your app stays the system of record.
Add the steps around your product.
Extend prior auth, coding, or intake with the next step: eligibility, claims, or appeals through the same API.
Use your interface or ours.
Embed the API, use the prebuilt UI, or connect work items to your existing systems.
Behind your UI
Render API results in your product, or restyle our prebuilt UI components. Your brand stays on every screen.
Alongside the EHR
Foresight subscribes to EHR events — a locked note, a new charge — does the billing work, and writes back with guardrails and a full audit trail.
In your team’s work queue
Exceptions become work items your people can pull, assign, or auto-assign by API — in our queue, or written back into the system they already work in.
Resources for each billing task.
Each resource has endpoints, scoped keys, and webhook events.
Eligibility & benefits
Real-time 270/271 with normalized benefits, multi-source checks, carve-out detection, and coverage-change events.
POST /v1/claims/{id}/check-eligibilityemits eligibility.checked
Prior authorization
Packets assembled from the chart, payer questions answered with cited evidence, clinician sign-off, status tracked to decision.
POST /v1/prior-authorizationsemits prior_auth.approved
Claims
Validate, scrub against NCCI and payer rules, apply fixes, submit, and track to payment across clearinghouses.
POST /v1/claims/{id}/scrubemits claim.paid
Denials & appeals
Denials classified by CARC/RARC with a recommended next action. Appeal letters generated and sent by fax, portal, or payer API.
POST /v1/appeals/{id}/generate-letteremits appeal.won
Credentialing
NPI validation, exclusion checks, license tracking, and enrollment state per payer and transaction.
POST /v1/credentialing/verifyemits credentialing.verified
Work & routing
Exceptions as work items: pull, assign, or auto-assign by skill, dollar value, and SLA.
POST /v1/work/auto-assignemits work.assigned
Webhooks
Subscribe once; every event these resources emit arrives HMAC-signed, with replay protection and automatic retries.
POST /v1/webhooks/subscriptionssigned · retried
Patients & encounters
Demographics, encounters, code derivation with provenance, and batch claim creation.
POST /v1/encounters/{id}/derive-codesemits encounter.coded
Authentication, environments, and retries.
API conventions your engineers can evaluate before integration.
- Auth
- Org-scoped API keys (fsk_…) with granular scopes, passed in a header.
- Environments
- Production, staging, and sandbox — same API, one header to switch. Sandbox data is synthetic, never live.
- Idempotency
- Idempotency-Key on writes. Retries are safe by design.
- Pagination
- Offset pagination with a hasMore flag. No cursors to babysit.
- Versioning
- Version lives in the path (/v1). Breaking changes get a new major version and at least 12 months of overlap.
- Rate limits
- 1,000 requests per hour per key by default, configurable per key.
- Errors
- A flat JSON envelope with machine-readable codes and field-level details.
- Webhook delivery
- HMAC-SHA256 signatures, replay protection, automatic retries, at-least-once semantics.
Foresight API docs and sandbox, on request
Full request and response schemas for every endpoint, end-to-end workflow walkthroughs, and compliance documentation. Sandbox access is provisioned per engagement under a BAA.
Request accessReview controls and data protection.
Low-confidence decisions become work items that explain what’s missing.
Confidence-scored
Every answer is scored and gated. Set automation and review thresholds per client and payer.
Cited
Payer-policy findings carry a citation: the source policy and its effective month.
Audited
An append-only audit log, enforced at the database, with a 7-year retention floor.
HIPAA
A BAA is signed before any PHI moves. PHI lives in AWS us-east-1 and nowhere else.
Encrypted
KMS-managed keys at rest (FIPS 140-2 validated), TLS 1.2+ in transit. SOC 2 Type II in progress.
Access-controlled
Scoped keys on the API. MFA and passkeys on the dashboard.
Payer-policy coverage varies; gaps route to review. The pilot measures automation on your workflows and payer mix.
Partner questions.
Bring the rest to a technical session — we’ll go as deep as your engineers want.
01Can we white-label it?
Yes. The API is headless — your UI, your brand, your customer relationship. Customizable UI components are available for teams that want a ready-to-use billing interface.
02Who owns the client relationship?
You do. Foresight is the machinery behind your product or your service. We don’t market to, bill, or contact your clients, and we’re never patient-facing.
03How do exceptions reach our team?
However your team already works. Pull from the work API, let auto-assignment route by skill and dollar value, or have items written back into the client’s system. Every item arrives with what’s missing and the proposed fix — not a mystery to re-investigate.
04Do you replace our client’s staff?
No. Automation handles keying, checking, and status-chasing so clients can focus on exceptions, growth, payer contracting, and front-desk work.
05How long does an integration take?
A first authenticated request takes minutes. A scoped pilot — one workflow, one client, one payer cohort, measured on precision and touchless share — typically stands up in weeks. Most partners start there and expand.
06What does it cost?
Usage-based, by workflow and volume, with partner pricing built for resale and bundling. Bring your volumes and we’ll put numbers on the first call.
Pick a workflow.
We’ll wire the pilot.
Pick a step that hurts, like benefit verification, prior auths, or advanced claim scrubbing. We run a sample and report the results so you can decide on evidence instead of a promise.
What a pilot reports
Coverage / fieldspayers resolved
Precisionfield-level correctness
Touchless shareno human touch
Human minutesper exception item
Integration effortmeasured, not guessed