Your contracts are the rules.
We make them enforceable.
Your payer contracts become executable logic. Know how a claim will process before you submit it. See exactly why it was denied. Verify every payment against the contract. One source of truth for your revenue cycle.
You negotiated the rate. Are you getting paid it?
By the time your team spots the pattern, the timely filing window has closed on hundreds of claims.
See how verification worksWithout the contract logic, you're flying blind.
Underpaid. Denied. Rejected for missing info. Without checking every remittance against every contract term, you don't know which denials to appeal, which underpayments are systematic, or what to fix before you file.
How it works.
Your contracts become executable specifications. Payments are verified against the negotiated terms as remittances arrive.
Your contracts become executable logic
Payer contracts, fee schedules, and rate escalators go in. Every reimbursement rule comes out as a unified specification that defines what you should be paid.
Predict. Verify. Explain.
Before submission: flag missing info and predict denials. After payment: verify amounts against contract rates. After denial: explain why, and whether to appeal or fix the process.
Recover. Appeal. Fix.
Every finding traces to a contract clause. Underpayments include the exact variance and §reference. Wrongful denials include appeal evidence. Valid denials include root-cause analysis so you fix the upstream issue.
The full contract, modeled as logic.
Base rates. Modifier rules. Carve-outs. Every layer of contract logic, modeled so it predicts, verifies, and explains at every stage of the claim lifecycle.
What the contract logic reveals.
Every underpayment explained. Every denial decoded. Issues flagged before submission. These patterns repeat until someone checks.
Contractual rate increases not loaded by payer.
Annual escalator clauses require payer systems to update fee schedules. Loading delays mean every claim filed in the gap pays at the prior-year rate.
Wrong base year and missing contract multiplier.
Payer loaded the prior-year Medicare fee schedule AND applied Medicare-level rates instead of the negotiated 115% multiplier. Two errors compounding on every claim.
Every denial decoded. Next step clear.
Wrongful denial? The contract clause is matched, the appeal evidence is ready. Valid denial? The root cause is traced (expired auth, missing modifier, wrong place of service) so you fix the process upstream and stop it from recurring.
Same patterns. Thousands of remittances. Verification catches them before filing deadlines expire.
From reactive to predictive.
Predict issues before submission. Explain denials immediately. Catch underpayments at the point of payment. Contract logic makes the shift possible.
Send us one contract.
See what the logic reveals.
Start with a single high-volume payer. Within a week, you see every underpayment, every denial explained, and what gets caught before submission. No system replacement required.