Building institutional memory for healthcare revenue cycle.
Healthcare reimbursement appears rules-based. In practice, enforcement varies — and the gap between written policy and real-world enforcement is where denials get won or lost.
The insight that drives everything
MCG and InterQual define medical necessity requirements. But how payers enforce those requirements varies — by payer, plan, reviewer, and timing. The same documentation that works for Aetna gets denied by Cigna.
Experienced billers know this. They’ve learned which evidence combinations work for which payers. The problem: that knowledge disappears — trapped in email threads, one person’s head, or lost when staff leave.
What we’re building: institutional memory as software.
Why now
Our approach
Calm over chaos
We build systems that reduce fire drills, not create them.
Clarity over assumption
We capture what actually works — not what should work in theory.
People before process
The goal is to make experienced billers more valuable, not to replace them.
Our moat
Evidence sequencing — Competitors log what was submitted, not submission order. Requires 12–18 month data retrofit.
Human-governable precedents — Billers read, challenge, update. Model weights can’t be governed.
Corpus depth — Building the deepest structured precedent corpus in behavioral health RCM — 500+ precedents by Q4 2026.
Contact
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