Automation Modules

Universal Data Normalizer

formerly Data Transformation Wizard

Healthcare data rarely arrives clean or consistent. HL7 messages come in from multiple source systems, each running a different version of the standard and structuring patient demographics, diagnoses, and procedures slightly differently. This pipeline extracts HL7 v2.x messages from three simulated source systems (v2.3, v2.4, and v2.5.1), transforms them into a single standardized common format, and loads the results into per-practice CSVs and a consolidated JSON repository.

Patient demographics, provider info, ICD-10 codes, CPT codes, and encounter metadata all map to the same schema regardless of where they came from.

Pre-Claim Eligibility Verifier

formerly Realtime Eligibility Bridge

One of the fastest ways to lose revenue is to see a patient before confirming their insurance is active. This module automates extraction and verification of patient insurance data using ANSI X12 271 response files, and translates all cryptic codes into plain English so your team knows exactly what they are looking at before any service is rendered.

The bridge sits between your incoming eligibility data and your operations team. Everything gets parsed, translated, and validated before anyone has to make a decision about it.

Claim Error Preflight

formerly 837 Claims Scrubber

A claim that gets rejected by the payer costs time, money, and significant rework. This module catches those problems before the claim ever leaves your building. It runs four distinct validation layers, from schema enforcement all the way through historical denial-risk intelligence powered by your own denial database.

Enrollment Acceleration Tracker

formerly Enrollment Velocity

A provider signs a contract, then waits. The entire time they sit in pre-revenue status the practice is paying their salary but not collecting from their patient visits. This module tracks exactly where every provider is in the enrollment process, syncs with NPPES and PECOS data, and gives you a real-time Revenue Readiness score so you always know who is stuck and where.

Intelligent Remittance Engine (EOB to 835)

Many practices still receive remittance information as PDFs. The data is there, but locked in a format that cannot be used for automation, reporting, or denial management without manual entry. This module converts those PDFs into ANSI-standard 835 files so the data is structured, actionable, and ready to work with.

Built to the CMS 835 TR3 5010A1 specification. Handles all required segments and dynamically maps situational segments like MIA and MOA when the data is present. A built-in reconciliation engine verifies that check amount equals the sum of claim payments plus adjustments before any 835 is generated.

Denials Intelligence and Recovery

Most denial reports tell you what got denied, but not what to do about it. This engine reads electronic remittance files across 16 practice types, loads claims into a database with adjustment and remark code intelligence, and routes each denial to the team best equipped to resolve it based on denial type.

Expected adjustments like CO-45 and PR-1/2/3 are handled by auto-post logic before they reach the denial queue. What remains is only the work that has a path to recovery, routed directly to the right person with the context they need to act.

A/R Command Engine

Most aging reports show what is past due. They do not show what is at risk, what to work next, or what to escalate. The A/R Command Engine reads your 837 claim files and 835 remittance files and builds a board-ready picture of your revenue cycle: aging buckets, days in accounts receivable on the 90-day method, payer rollups, and at-risk flagging tied to each payer's actual timely filing limit.

Built for two audiences in the same module. Revenue cycle teams see exactly what to work next, sorted by recovery probability and timely filing risk. CFOs and operators see the same numbers in real time without waiting for a monthly export.