Find what your last audit missed.
Evidence-backed claims audit for TPAs, carriers, RCM teams, and DSOs — with a traceable chain of custody behind every finding.
Surface overpayments and compliance gaps. Export defensible proof.
No PHI required for the first sample report.
Each finding links to its rule and source citation.
The problem
Manual claim review doesn't scale — and it misses things
Auditors read PDFs line-by-line, cross-reference fee schedules by hand, and try to hold dozens of compliance rules in their heads across hundreds of claims a week. Fatigue creates blind spots. Blind spots become liabilities.
Unbundled and duplicate codes slip through during high-volume periods.
CPT/ICD-10 mismatches go unnoticed without a lookup table in front of you.
Missing prior authorization only surfaces after payment.
No audit trail means no defense when an examiner asks.
How it works
Upload → flag → review → export proof
Upload a claims batch
Drop in PDFs or CSVs. Enterprise integrations are scoped during pilot setup. Documents are classified automatically and structured claim data is extracted.
Instant flag detection
Consistent, explainable, traceable — a deterministic rules engine checks every configured compliance rule in milliseconds per claim.
Review, decide, export
Auditors review flagged items beside the redacted document text, then export a signed-off PDF for the record.
What you get
Three documents, ready to hand to compliance
Findings report (PDF)
Opens with Top Findings by Amount at Issue, then every flag with its regulatory reference and the exact rule that fired.
Tamper-evident audit trail
A hash-chained record of every rule version, extraction version, reviewer, decision, and timestamp — chain-of-custody for each finding.
Provider disclosure
A redacted, PHI-safe disclosure document generated straight from the run — names, dates, and identifiers masked.
Security & compliance
Built for PHI from the first byte
PHI redaction before analysis
Personal and protected health data is scrubbed before any processing or export.
Row-level tenant isolation
Every record is scoped to one client. Cross-tenant access returns nothing.
Encryption in transit & at rest
Data is encrypted on the wire and on disk across the platform.
BAA-ready for live claims
Live-claim work runs under a Business Associate Agreement and secure upload.
Full security architecture available on request. Security overview →
Get a sample report on your book
Start with a PHI-free sample audit — the findings report, chain-of-custody trail, and provider disclosure your team would receive on a real claims batch. You keep it whether or not you go further.
Live-claim audits run under BAA and secure upload.
Get a sample report →Pricing
Pick the plan that fits your book
Fixed monthly pricing with included claim volume — no per-flag billing and no recovery-contingent fees. Start PHI-free with a Ghost Audit.
Starter
From $2,500/mo
One book of business, up to 2,500 claims/month.
Growth
From $5,000/mo
Multi-client teams, up to 15,000 claims/month.
Enterprise
Custom
High-volume books, integration scoping, security review, and SLA.
Every plan includes deterministic rules, human review, the tamper-evident chain-of-custody trail, findings PDF, provider disclosure, and XLSX workpaper. Live-claim work runs under a BAA.