Know what you're owed.
Prove it.
Your payer contracts become executable logic that verifies every payment, explains every denial, and proves what you're owed.
For hospitals, health systems, payers, and plan sponsors.
The gap between contract and outcome.
Denied. Underpaid. Rejected for missing info. None of it is random. Every pattern traces back to how contract logic was loaded, interpreted, or ignored.
Repeated across 847 CPT codes for 5+ months
Silent downcoding across 3,200+ E&M claims per quarter
Would have been caught pre-submission. Now facing timely filing risk on appeal.
180+ claims with same pattern, appeal evidence ready
These aren't edge cases. They're systematic patterns that repeat until the underlying logic is checked.
Your contract is the rulebook.
Make it machine-readable.
Traditional workflows chase denials after the fact and miss underpayments entirely. Contract logic changes that. Predict denials before submission. Understand why they happen after. Verify every payment in between.
Your contracts become executable logic.
Contract language becomes formal logic. Predict how claims will process. Verify every payment. Explain every denial. Traceable to the clause.
“Apply Modifier 59 when services are performed at distinct anatomical sites or during separate encounters”
Predict
Know how a claim will process before it settles. Flag missing info and likely denials pre-submission.
Verify
Check every payment and determination against the contract. Catch underpayments and wrongful denials.
Explain
Every finding traces to a contract clause. See why a claim was denied, underpaid, or flagged.
Any logic that determines payment.
From simple rate lookups to complex multi-step rules, we model the full decision tree and verify every path.
Service date falls 3 days after coverage termination. Retroactive term from employer.
These are examples. If your contracts define it, we can verify it.
Recover what you lost. Prevent what you haven't.
Look back at historical payments. Watch transactions in real time. Optimize your contract terms. Same verified logic, three ways to use it.
Start with any solution. One contract model powers all three.
If contracts determine your payments,
we can verify them.
Payers, hospitals, and anyone tired of spreadsheet reconciliation and payment disputes.
Have a different use case?
What this means for your organization.
Contract errors compound silently. Verified contract logic protects revenue and cuts the operational burden of finding what went wrong.
Recover what's already been lost
Surface underpayments, wrongful denials, and systematic errors sampling missed.
Predict issues before they settle
Know how claims will process. Catch underpayments and explain denials in real time.
Negotiate with real data
Model escalator structures, carve-outs, and stop-loss terms against actual claims.
Built for healthcare data.
Claims data is sensitive. Our infrastructure, processes, and team are designed around that from day one.
SOC 2 Type II
Independently audited controls for security, availability, and confidentiality. Reports available under NDA.
HIPAA Compliant
Full administrative, physical, and technical safeguards. BAA executed before any data is shared.
No EHR integration required to start. Ingest claims data via file upload or warehouse connection. Compatible with Epic, Cerner, MEDITECH, and any system that produces 837/835 files.
See what your contracts
are actually doing.
See what your contracts
are actually doing.
Send us a contract and a sample of claims. Within a week, you see every underpayment, every denial explained, and what would get caught before submission.