Anomaly
Anomaly is an AI-powered payer management platform built for healthcare revenue teams to “know your payers as well as they know you.” It surfaces hidden payer behaviors by decoding complex rules and detecting payment patterns across hundreds of millions of healthcare encounters. The core engine, Smart Response, continuously analyzes payer logic, adapts to shifting policies, and embeds learnings directly into existing revenue cycle workflows to provide real-time denial prediction, assisted claims correction, and alerts to revenue risks. By integrating payer-specific insights into existing systems, users can anticipate revenue loss, negotiate payer contracts from a stronger position, and proactively correct or reverse denials before they impact cash flow. The system helps level the playing field between providers and payers by turning opaque billing logic into actionable intelligence and embedding it into day-to-day financial operations.
Learn more
MDaudit
MDaudit is a cloud-based platform that unifies billing compliance, coding audits, and revenue-integrity workflows for healthcare providers, hospitals, physician networks, ambulatory surgical centers, and the like. It supports all types of audits, scheduled, risk-based, retrospective, and denial-focused. MDaudit automates data ingestion from pre-bill charges, claims, and remittance data; triggers audit workflows; flags anomalies and high-risk patterns; and delivers real-time dashboards and drill-down analytics revealing root causes of billing errors, denials, and revenue leakage. Its modules, including a “Denials Predictor” for pre-submission claim validation and a “Revenue Optimizer” for continuous risk monitoring, help organizations prevent claim denials, reduce recoupments, and capture more legitimate revenue. MDaudit also provides payer-audit management: a secure, centralized workflow to respond to external audit requests and manage documentation exchange.
Learn more
Athelas
Athelas is an AI-driven RCM, EHR, and ambient AI platform built to grow modern healthcare organizations. It brings revenue cycle management, clinical documentation, EHR workflows, and healthcare AI agents into one practice platform designed to accelerate payments, reduce administrative work, and help providers focus on patients. Athelas RCM transforms claim management, denial defense, remittance reconciliation, and reimbursement tracking with AI-powered tools that identify the right approach for each claim, automate portal information retrieval, extract payer decisions from the web or phone calls, and surface insights into practice financial health. Ambient AI works as more than a scribe, adapting to each clinician’s documentation style, automatically syncing chart notes to the EMR, generating CPT and ICD-10 codes, supporting parallel scribing, answering questions, retrieving data, running tasks, and providing compliance nudges during encounters.
Learn more
InvisaClaim
InvisaClaim AI Revenue Cycle Management that prevents denials and wins the ones that slip through.
The most advanced all-in-one platform for billing companies and RCM teams. Before claims go out, Pre-Submission Check and Pre-Check AI scrub them against NCCI edits, coding conflicts, and payer rules stopping denials at the source. When one slips through, upload or live-feed a denial letter or 835 ERA and AI extracts patient data, CARC/RARC, CPT/ICD-10, amounts, and deadlines then drafts a payer-specific appeal in 60 seconds across 30+ payers.
Modules: Pre-Submission Check, Denial Workbench, NSA/IDR (eligibility, QPA, GFE & IDR letters), Prior Auth, A/R aging, NPI verification, deadline alerts, full audit trail.
Connects to your clearinghouse and EHR: Change Healthcare/Optum, Waystar, Availity, Athenahealth (pipeline), plus a FHIR R4 layer for EPIC/Cerner.
HIPAA Compliant · SOC 2 · 256 Encryption
Learn more