Revenue and charge reconciliation
Charges, claims, remits, and postings matched across systems, down to the 835 that answers an 837 it does not match, with every unmatched dollar surfaced as a case.
AI revenue management for healthcare
We run reconciliation and denial recovery inside your systems, or own the outcome end to end.
Book a chatThe revenue is earned. Collecting it is where the cost sits.
- $25.7B
- Spent adjudicating claims
- 70%
- Overturned
- $57
- Per claim
What providers paid in 2023 to argue claims with payers.
Of denials, the share overturned and paid.
Average cost to adjudicate one claim, up from $44 in 2022.
About 70% of denials are overturned and paid
Premier Inc., 2023 claims data, published 2025.
Revenue leaks three ways: records that do not match, cases that sit, windows that expire. Nearly $18 billion of 2023's adjudication cost was potentially wasted on claims that should have been paid at submission.
Recovery is hand work, multiple rounds when fought, and a missed window is a permanent write-off. Earned revenue expires in worklists while volume keeps climbing.
Reconcile the records. Decide on your policy. Act, and prove it.
The loop, run per case
- 01
Reconcile
Records from your billing system, the clearinghouse, and the payer come together as one case. Matches are explicit, conflicts are surfaced.
- 02
Decide
Your policy, applied. Deterministic checks run beneath the model, so every judgment stays inside bounds you set.
- 03
Act
The next step gets completed in the system that owns it: the rebill, the appeal, the posting.
- 04
Prove
Every action logs what happened and why, readable by an auditor months later.
Built for work that tolerates no wrong answers
You decide what runs automatically and what waits for review. Policy is enforced deterministically beneath the model, so the rules never move. Every case closes with a record built for the payer dispute or the compliance review, years later.
If we cannot say what the system does at every branch, we do not take it on.
The workflows we take on first
Denial recovery
Each denial read against the payer contract and your policy, the appeal drafted with the basis attached.
Bring a different workflow and we will tell you plainly whether it is one we can bound.
What happens to your data
- Access
- Read-only by default. Writes happen only inside a scope agreed in writing.
- Model training
- We never train models on your data.
- Model calls
- They can run under your own key.
- HIPAA and BAA
- We sign a BAA with every customer before any patient data moves.