Eligibility, prior authorization, claims, denials, appeals, and remittance — one REST API, signed webhooks, and a work queue for the exceptions. Build revenue-cycle features into your product without hiring a billing department or writing X12 by hand. An embedded UI is available too.
For RCM firms, scribe platforms, EHRs, and health-tech vendors that want to capture more revenue and serve the clients they know best end-to-end.
RCM firms, scribe platforms, EHRs, and point solutions run on the same API — under their own brand, inside their own workflow.
Keep the client relationships and the systems your clients already run. Foresight adds the decisioning layer — eligibility, payer-policy checks, prior auth, claim status, and scrubbing through one API. Anything uncertain routes back to your queue, your bots, or the client’s system, so your team works exceptions instead of keying data.
Your product already produces the note and the codes. Foresight turns them into revenue: claims scrubbed against payer policy, submitted, tracked, and posted — under your brand. Clinics stop stitching together point solutions, and you stop handing the billable step to someone else.
Practices leave good EHRs over weak billing. 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.
You automate one step well — prior auth, coding, intake — and customers keep asking for the step after it. Add eligibility before the auth, the claim behind it, the appeal if it denies. Same API, no second vendor.
Three ways teams wire Foresight in. Most start with one workflow and grow from there.
Call the API and render results in your own product, or drop in our prebuilt UI components and restyle them to match. Either way your brand stays on every screen and your users never see Foresight.
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.
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.
Every capability is a resource with endpoints, scoped keys, and webhook events — not a feature behind a sales call.
Real-time 270/271 with normalized benefits, multi-source checks, carve-out detection, and coverage-change events.
Packets assembled from the chart, payer questions answered with cited evidence, clinician sign-off, status tracked to decision.
Validate, scrub against NCCI and payer rules, apply fixes, submit, and track to payment across clearinghouses.
Denials classified by CARC/RARC with a recommended next action. Appeal letters generated and sent by fax, portal, or payer API.
NPI validation, exclusion checks, license tracking, and enrollment state per payer and transaction.
Exceptions as work items: pull, assign, or auto-assign by skill, dollar value, and SLA.
Subscribe once; every event these resources emit arrives HMAC-signed, with replay protection and automatic retries.
Demographics, encounters, code derivation with provenance, and batch claim creation.
The parts you’ve built against a hundred times behave the way you expect — and the docs are ready when you are.
Full request and response schemas for every endpoint, end-to-end workflow walkthroughs, and compliance documentation. We share it on request, and sandbox access is provisioned per engagement under a BAA — so your engineers evaluate against the real thing, not a PDF.
Request accessEvery automated decision carries a confidence score and a review disposition. Thresholds are yours to set — per client, per payer, aggressive or conservative. Low confidence never means a silent guess; it means a routed work item that says exactly what’s missing.
Every automated answer is scored and gated. You set where auto-submit ends and review begins.
Payer-policy findings carry a citation: the source policy and its effective month.
An append-only audit log, enforced at the database, with a 7-year retention floor.
A BAA is signed before any PHI moves. PHI lives in AWS us-east-1 and nowhere else.
KMS-managed keys at rest (FIPS 140-2 validated), TLS 1.2+ in transit. SOC 2 Type II in progress.
Scoped keys on the API. MFA and passkeys on the dashboard.
Boundaries, stated up front: payer-policy coverage varies by payer — gaps route to review, never to a guess. Automation rate is an observed result, not a number we promise before we’ve seen your workflow.
Short, honest answers. Bring the rest to a technical session — we’ll go as deep as your engineers want.
Pick the step that hurts — benefit verification, prior auth, claim status. We run an agreed sample and report the numbers, so you decide on evidence instead of a deck.