For insurers
Verify claims by inspecting the transformation chain instead of requesting source paperwork.
Review today — and with the chain
Today
- Requesting source paperwork and waiting for the clinic's reply.
- Manually matching a code against free-text notes.
- Arguing over reconstructions: whose version of events sounds better.
- Repeated review cycles for most contested claims.
With the transformation chain
- For every line — the source fragment, term, descriptor, code, tariff.
- A version and an author at every link; the check is reproducible.
- Per-line decisions are recorded — the dispute does not reopen.
- A non-repudiable reconciliation record protects the expert's decision.
The reconciliation panel
A joint workplace: your expert and the clinic’s representative see the same chain for every contested line — in the minimum necessary scope, with no access to the patient chart. The subject of reconciliation is evidence of care delivered, not correspondence. The output is a reconciled act with a per-line decision record.
Programmatic screening of incoming claims
Registries are screened programmatically — via the API or the standard agent profile: lines without a reliable chain are flagged before manual review. Your experts work the disputed, not everything.
The anchor-payer program
The first insurer in the program receives special terms and a voice in shaping the reconciliation panel around its own procedures. A two-sided product works so that the side that adopts the tool first sets the standard for its counterparties.
Discuss the anchor-payer program?
Become the anchor payer