Clinical Intelligence for Healthcare Operations
We extract structured clinical evidence from unstructured medical records — progress notes, pathology reports, hospice certifications — enabling providers to submit clean, evidence-backed claims, and allowing payers and federal programs to make faster, more accurate clinical determinations.
Request a Technical Briefing →Per-document clinical extraction
Source-cited evidence trail
Net-new burden on existing workflows
The Documentation Review Bottleneck
The friction between provider submission and payer review creates a massive documentation bottleneck. Providers spend countless administrative hours compiling clinical evidence to meet Medicare, Medicaid, and commercial claim requirements. Federal reviewers and payers spend hours manually reading those same unstructured records to extract the relevant evidence.
Our platform bridges this gap. We automate the evidence extraction step at the point of submission or review. Providers know exactly what evidence they are submitting, and reviewers receive structured, source-cited clinical data mapped to the specific criteria they need to evaluate. The clinical judgment remains human. The data extraction becomes automated.
Solutions
Production-ready clinical intelligence across the care and payment lifecycle.
Program Integrity & Medical Review
Automated evidence extraction for medical necessity reviews, post-payment audits, and fraud investigations.
Risk Adjustment Validation
Clinical congruence determination for HCC validation and RADV encounter review.
Prior Authorization & Clean Claims
Pre-submission evidence extraction and denial prevention for oncology and specialty pharmacy.
Quality Measurement & HEDIS
Unstructured data extraction for HEDIS measure closure and STAR Ratings improvement.
Who We Serve
Federal Programs
Medicare program integrity, medical review operations, and federal quality measurement initiatives. We support clinical evidence extraction workflows for encounter review, certification validation, and coverage determination processes.
Health Plans
Medicare Advantage, Medicaid managed care, and commercial payers. We deliver payment accuracy, risk adjustment validation, and quality measurement capabilities that reduce manual chart review burden and improve determination accuracy.
Provider Organizations
Oncology practices, health systems, and specialty groups. We automate documentation workflows to ensure first-pass claim acceptance, reduce prior authorization denials, and eliminate administrative hours spent compiling clinical evidence for payer submissions.
Technology Partners
EHR vendors, revenue cycle platforms, e-prescribing networks, and clinical data aggregators. We integrate clinical NLP capabilities into existing workflows via FHIR API, enhancing clinical intelligence at the point of prescribing, review, or submission.