Three instruments built for hospital revenue cycle directors. Pull HCPCS codes the day the patient leaves. Audit every claim for the leak compliance audits miss by design. Catch encounter overlaps before submission. One floor. Nothing falls below it.
Tier 1 — Start here
Reads the printed HCPCS superbills, CMS 1500 forms, and clinic tick sheets that still move through every hospital. Returns submission ready rows in roughly a second and a half.
Three layers stand between paper and the claim: a deterministic PyMuPDF preprocess that handles clean scans without burning an LLM token, a two model consensus across claude-sonnet-4.6 and claude-opus-4.7 that catches its own mistakes before output, and a crosswalk validator against the current CMS HCPCS Level II dataset with payer specific modifier rules. Nothing is retained. BAA executed before first production use.
Want to know what's leaking from the claims you already submitted?
Tier 2 — The audit layer
Across a 50,000 claim year the gap is typically three to eight percent of gross revenue. Real money. Quietly lost. Invisible to compliance audits by design.
ClaimAct reads every inpatient claim leaving the hospital and asks one question: did this capture the full severity of what actually happened? Shadow Leakage Audit, EMV Dispatch, HTLOS Outlier Monitor, and Portfolio Exposure Scanner all run in browser with no backend. ClaimAct makes the leak visible before the claim leaves the building.
Want to stop overlap rejections before they happen?
Tier 3 — Pre submission integrity
Detects encounter overlaps that trigger CLAI 008 denials. The denial you prevented is the one that pays you back.
MergeAct catches the CLAI 008 collisions that bounce every overlapping encounter back from SEHA, Medicare, and most commercial payers. Identifies overlap before submission, before the payer adjudicates, before the denial enters your rework pipeline. The denial that never gets filed is the cleanest claim in the system.