The semantic document gateway

The claim that won't bounce back

HealthOS Semantics turns medical documents and physician visits into defensible claims: every line is provably traceable to a fragment of the source document or speech. Disputes are resolved by presenting the transformation chain — not by re-examining scattered paperwork.

Request a pilot How it works

For clinics, insurers, medical-software vendors and physicians.

Why claims bounce

11.8%initial claim denial rate
25%of causes are coding errors
$43.84cost of working one denial
70%of denied claims eventually get paid

US market, 2025; sources. The root cause is the same on any market: the code on the claim is not provably linked to the document content — the parties argue over reconstructions.

How it works

How a document becomes a claim line: seven links in the transformation chain.

The system takes a document or an audio recording of a patient visit as input and turns it into a claim line step by step:

  1. the grounding fragment is located in the text
  2. a term is extracted from the fragment
  3. the term is bound to a descriptor in the graph
  4. the descriptor receives a code
  5. the code is assigned a tariff
  6. the tariff becomes a line on the claim.
How it works The diagram shows the path of a document or visit recording through seven links: document, the grounding fragment in the text, a term extracted from the fragment, a descriptor in the graph, a code, a tariff and the claim line itself. Each link has a version, an author and a cryptographic digest. Documentor visit recording Fragmentthe grounding text Termextracted from fragment Descriptorversion · author CodeICD-10 · services Tariffservice price Claimact and registry line

Seven stages of one pipeline, each stage a transformation with evidence — version, author and cryptographic digest. The result is a transformation chain for every fact, with the lineage of every statement behind every claim line. The evidence behind the transformations is one click away.

More about the chain →

The decision core — rules and people

The decision core is deterministic rules and people. Behind a conclusion stands a rule with a version, so the same document yields the same result; anything disputed is blocked and goes to a human for authorization — in the four places where the decision must be accountable. No trainable models sit in the decision loop.

Act panel

A disputed line is resolved before submission, not after denial.

Dispute panel

A denial position in minutes: the line's history is already assembled.

Reconciliation panel

Clinic and insurer see the same chain of evidence.

Binding panel

Disputed term recognition — a choice between grounded candidates.

All four panels →

Who it is for

  • A claim that won't bounce: disputes resolved before submission.
  • Denials worked in minutes — the line history is already assembled.
  • Less frozen revenue and a cheaper dispute cycle.

More for clinics →

Wondering what denials cost you?

Loss calculator Request a pilot
HealthOS Semantics is not a medical device and is not intended for diagnosing conditions or selecting treatment. All decisions are made by authorized professionals.