Predict issues before they pay.
Explain them when they do.
Your contracts become executable logic. Know if a claim will process correctly before it settles. When it doesn't, see exactly why and what to do next.
Executable Logic Model
Contract terms, fee schedules, escalators
Same error. Same system. Different outcome.
A rate escalator doesn't load. A claim gets denied for a covered service. The question is when you find out.
5+ months of underpayments before detection
Escalator not applied
Expected 2024 rate ($1,805). Got 2023 rate ($1,487)
Why errors and denials persist.
Every organization has controls. None verify that outcomes match the rules as written, or explain why a claim was denied.
Policy MN-2024-10352-day lag~340 claims/mo processed incorrectly
Executes configured logic
Doesn't verify the config matches policy
Silent downcoding looks like a normal payment
Catches fraud and outliers
Misses correctly-formatted underpayments
Variance accumulates for months
Reviews past claims quarterly
Finds issues months after they start
Each of these systems executes logic. None of them verify the outcome matches the contract, predict what will happen next, or explain why a claim was denied.
Your systems keep running.
Contract logic verifies every outcome.
No system replacement. No workflow interruption.
Predict outcomes before they settle. Explain denials when they happen.
Errors caught. Denials explained.
Real issues from real contracts. Caught in minutes, not months. Every denial decoded instantly.
115% Medicare + 3% escalator$1,805.23115% Medicare, no escalator$1,487.00The cost of delay cascades.
A contract error doesn't just affect claims. It triggers recovery operations, filing deadlines, and disputes that compound with every passing day.
Hospital contracts typically allow 90-180 days for filing. Once that window closes, underpayments become unrecoverable.
Value-based care settlement disputes typically allow 60 days. Attribution errors found after that window are unrecoverable.
Self-funded plans have a fiduciary duty to members. Known errors that persist create attestation risk for plan sponsors.
See value in days.
Not quarters.
No integration project. No workflow disruption. Your contracts become executable logic that predicts, verifies, and explains every claim outcome.
See results on real claims data
Know how a claim will process before it pays
See why it was denied and whether the contract supports it
See how this applies to you