Claima — AI Revenue Cycle Management

• Eligibility and benefits: real-time 270/271 verification with plain-English coverage summaries (deductible, copay, coinsurance, prior-auth requirements).
• Claim creation and scrubbing: builds compliant 837P claims and uses AI to scrub each one before submission, flagging coding, modifier, and medical-necessity issues that cause denials.
• Submission and tracking: submits to payers through an integrated clearinghouse and tracks status end to end.
• Denial management and recovery: parses remittances, classifies every denial by CARC/RARC, drafts payer-ready appeal letters with AI, and recovers denied and underpaid claims.
• Payment posting: auto-posts ERAs/835s, reconciles payments, and routes patient balances.
• Patient billing: statements, payment links, and card collection.

Beyond core billing, Claima extends across the practice's revenue operations: prior-authorization tracking, provider credentialing and payer enrollment, chronic care management (CCM) time tracking, OIG exclusion screening, and payer-level intelligence that benchmarks denial and collection rates so practices see exactly where revenue is leaking.

Built for practices of every specialty, Claima is priced on a percentage of what it collects, aligning our incentives with the practice's. It is HIPAA-compliant, with Business Associate Agreements executed, encryption in transit and at rest, multi-factor authentication, per-practice data isolation, and full audit logging. AI features run only on providers covered by a signed BAA.

The integration reads claims, remittances, charges, eligibility, and patient/insurance data to power these workflows.