Healthcare Studio
hOS — The Healthcare Operating System

Healthcare connects people.
We connect healthcare.

Every denied claim, missing auth, and miscoded encounter is a gap between systems. Healthcare Studio closes the gaps — not with dashboards, but with agents that partner with your team to turn denials into recoveries and gaps into paid claims.

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0%+
Denials overturnable
0 in 0
Never reworked
$0
Avg. cost to rework a claim

The denial problem doesn't get easier on its own.

US payer denial rates have risen every year for five consecutive years. India-based RCM firms absorb the volume — without scaling headcount linearly.

$0
admin cost to rework a single denied claim
Staff time, portal access, documentation retrieval — before a single appeal letter is drafted
0 in 0
denied claims are never reworked
Most practices write off denials rather than appeal — the manual workload makes rework economically irrational
0%+
of denials are overturnable on appeal
But most RCM firms don't pursue them — manual appeal workload is too high
0%
of denials originate at the front end
Eligibility mismatches and prior auth gaps preventable before submission

Apps that do the work.
Not dashboards that describe it.

RCM software gives you dashboards. Healthcare Studio gives you outcomes. Apps handle the repeatable — parsing remits, verifying coverage, reviewing codes — and co-pilot with your team on the rest, so specialists stay focused on decisions that move revenue.

Parse, don't translate
X12 5010 and FHIR R4 read natively — no connectors, no ETL, no middleware to maintain. Your 835 ERA is structured data the moment it arrives.
Audit by default
Every agent action logged. Every human decision recorded. Full trace from file-in to appeal-out. HIPAA-ready from day one — not bolted on later.
Human-in-the-Loop
Your specialists stay in control. The app handles the 80% that's repeatable. Your team handles the 20% that needs clinical judgment. Autonomy expands as confidence builds.

Built. Running. Not a roadmap slide.

Three apps carry the revenue cycle end to end — from before a claim ships to after a payer says no. What follows is real, at a resolution that proves it without handing you the blueprint.

Lifecycle Visibility · Provider · Live

Know a claim's health before the payer tells you.

Every claim's status, denial linkage, remit resolution, and credentialing state in one view — no toggling between a clearinghouse portal and your PM system. Approval-probability scoring is fully specified in the same pipeline; it activates against your claims data the moment a pilot starts.

One view for status, denial linkage, and credentialing state — not three tabs across two systems.
Approval-probability scoring is spec-ready, not a future roadmap item — it turns on with your pilot data.
Built on the same canonical data model as every other app — a claim's health here is the same claim AR and Denial Management act on.
0%
of denials originate at the front end
0
canonical data layers unified into one health view
Claim Health
ClaimPayerDaysStatus
CLM-88213Aetna4Clean
CLM-88214UHC11At Risk
CLM-88215Cigna2Clean
CLM-88216BCBS19Denied
Collections · Provider · Live

Aging claims don't wait for someone to notice them.

AR Follow-up manages the queue of outstanding claims, tracks aging buckets, surfaces payer contact details, and logs every follow-up call. When a call surfaces a denial, the claim moves into Denial Management automatically — no duplicate entry, no lost context.

Claims aged past 90 days collect less than 50 cents on the dollar on average — we surface them before they pass the point of economic return.
A follow-up call that surfaces a denial hands the claim to Denial Management automatically.
Payer-specific timely filing limits are tracked so appeals don't expire while a claim sits in a queue.
35–0
avg days in AR (target: under 30)
0%
of AR value written off without follow-up
AR Follow-up · Aging
142
0–30d
68
31–60d
31
61–90d
14
90+d
CLM-77120HumanaCallback promised
CLM-77121AetnaEscalated
Back Office · Provider · Live

835 in. Root cause classified. Appeal drafted. Nothing skipped.

Reads 835 ERA remittance files natively, mapping denied claims to CARC and RARC codes and determining root cause — coding deficiency, medical necessity, COB, authorization gap, eligibility mismatch. Delivers a payer-specific, review-ready appeal letter, not a generic template.

835 ERA files read natively — no manual data entry, no CSV exports from your clearinghouse.
Appeal letters are payer-specific, each with CARC/RARC context and clinical rationale matched to the denial reason.
Every agent action is logged and every appeal is traceable, full chain from file-in to appeal-out.
0
in 3 denied claims are never reworked
0%
avg overturn rate for documented appeals
Denial Management · Triage
CLM-51009CO-197
Auth gapDrafted
CLM-51010CO-16
CodingSent
CLM-51011CO-29
Timely filingReview
Live

Eligibility Check

Front-end verification before the visit, not after the denial.

0%
of all denials are eligibility-related
  • Real-time 270/271 EDI verification
  • COB conflict detection & flagging
  • Prior authorization gap alerts
$0
avg cost to rework an eligibility denial
0%
reduction in front-end denials with pre-visit checks
Live

Credentialing

Every provider enrolled and current, with nothing expiring unnoticed.

0–120
days avg credentialing cycle
  • CAQH profile management & updates
  • License & DEA expiration alerts (90/60/30-day)
  • Re-credentialing cycle tracking
$0K+
revenue at risk per un-credentialed provider/mo
<0
days target cycle with automation
Live

Payment Posting

835s posted line-by-line, with exceptions routed the moment they appear.

0
posting dispositions tracked end to end
  • Auto-posts 835 remittance line-by-line against expected fee schedule
  • Flags fee-schedule variance before it's buried in a batch
  • Routes exceptions straight to AR Follow-up or Denial Management — no manual handoff
0
auto-routes on posting exceptions (AR or Denial Management)
0
835 file triggers posting, variance-flagging, and routing together

Built on healthcare-grade infrastructure

Every component selected for HIPAA compliance, US healthcare interoperability, and the specific demands of high-volume RCM operations.

AWS
HIPAA-Eligible Infrastructure
Signed BAA. PHI stays within your account boundary. AWS Bedrock hosts Claude — covered by the same agreement.
Claude
Anthropic Claude AI
Powers root-cause analysis, appeal drafting, and coding suggestions — structured output, chain-of-thought, full audit trails.
X125010
X12 EDI Native
835, 837, 270/271, 276/277 — grammar-driven parser, all segment variants, all major US payers.
HL7FHIRR4
HL7 FHIR R4 Native
EHR and PM system integration — eligibility checks, coding from clinical notes, claim status across systems.

Native to the data.
No middleware required.

Healthcare Studio reads X12 5010 and HL7 FHIR R4 directly — the same formats your payers, clearinghouses, and PM systems already produce. No translation layer, no custom connectors. Drop a file or point an API — it works.

Practice Management & EHR

Epic
Oracle Health
athenahealth
eClinicalWorks
NextGen
AdvancedMD
ModMed
Veradigm

Clearinghouses & EDI Networks

Change Healthcare
Availity
Office Ally
Trizetto

Compliance & Standards

HIPAAby Design
X12
5010
Native
HL7
FHIR
R4
Native
AWS
HIPAA-Eligible
Infrastructure
CMS
Open
Data
Integrated
BAA Ready

Questions people ask us.

Straight answers, at the stage we're actually at.

Shape the platform with us.

We are onboarding a small cohort of RCM operations teams to build alongside us. Tell us what you're working on — we'll tell you honestly whether and how we can help.

No lock-in. No pitch deck. 30 minutes.