03Claims

Claims built clean, routed to the right rail.

We build the claim, scrub it against payer-specific rules, and send it to the clearinghouse that handles that payer best.

Claim lifecycle

Clean claims go out on their own; the ones that need judgment surface with the fix already attached.

Scrubbing

Caught before the clearinghouse, not after

Every claim is checked for code validity, diagnosis-to-procedure linkage, duplicates, provider eligibility, and NCCI / add-on modifier rules before it leaves — with modifier suggestions surfaced on the claim.

Scrub gates

Each gate runs before submission — the fix is attached, not just the flag.

Routing

Each payer to the clearinghouse that handles it best

Submission and eligibility route per payer across multiple clearinghouses. Payers that only accept paper are handled too, generated and sent when required.

Per-payer routing

Per-transaction, per-payer routing — one router in front of several rails.

Exceptions

Clean goes out, edge cases surface with a fix

Most claims run on their own. The ones that need a human land in a prioritized queue with the problem identified and the suggested fix already attached — highest-dollar items on top.

Claims built clean, routed to the right rail.

Caught before the clearinghouse, not after

Each payer to the clearinghouse that handles it best

Clean goes out, edge cases surface with a fix

Bring a week of claims.
We'll show you the layer.

This capability

Caught before the clearinghouse, not after

Each payer to the clearinghouse that handles it best

Clean goes out, edge cases surface with a fix

Bring a week of claims. We'll show you the layer.

This capability

Bring a week of claims.
We'll show you the layer.