WORKFLOW MODULES (3)
AMBIENT FLOW
BACKGROUND CLINICAL PARSING
$0 up front — no minimum, no per-claim fee
A background parsing layer that helps reduce coding backlog before it turns into denials. It processes clinical notes into structured ICD-10/CPT data for review by your team.
- BACKGROUND CLINICAL PARSING
- ICD-10/CPT CODE SUGGESTIONS FOR REVIEW
- FEWER MANUAL TOUCH POINTS
- ENCRYPTED IN TRANSIT AND AT REST
- ACCESS CONTROLLED AND AUDIT LOGGED
CLOSED-LOOP RECONCILIATION
AUTOMATED PAYER RECONCILIATION
$0 up front — no minimum, no per-claim fee
Automated reconciliation of payer responses against your submissions to shorten accounts-receivable cycles. NorthStarClaim is a claim-recovery software service; it is not a bank, clearinghouse, or payment network.
- AUTOMATED PAYER RECONCILIATION
- SHORTER ACCOUNTS-RECEIVABLE CYCLES
- FEWER MANUAL TOUCH POINTS
- APPEAL DRAFTING SUPPORT — AUTONOMOUS, AUDIT LOGGED
- ENCRYPTED IN TRANSIT AND AT REST
HISTORY MATRIX
APPEND-ONLY CLAIMS LEDGER
$0 up front — no minimum, no per-claim fee
An append-only ledger of claim activity for historical reconciliation and audit review. No uptime or availability guarantee is implied.
- APPEND-ONLY CLAIMS LEDGER
- HISTORICAL RECONCILIATION
- ACCESS-CONTROLLED AUDIT RECORDS
- ROLE-BASED ACCESS CONTROL (RBAC)
- ENCRYPTED IN TRANSIT AND AT REST
BASELINE CAPABILITIES (3)
NORTHSTAR FOUNDATION
CORE SCRUBBER & VELOCITY MONITORING
$0 up front — no minimum, no per-claim fee
Entry-level claim scrubbing and velocity monitoring on existing pipelines, via read-only X12/HL7 hooks.
- FEWER MANUAL REJECTIONS
- READ-ONLY HL7/X12 HOOKS — LOW IT BURDEN
- CONTINUOUS CLAIM SCRUBBING
- ENCRYPTED IN TRANSIT AND AT REST
- ACCESS CONTROLLED
NORTHSTAR ENTERPRISE
DENIAL PARSING & APPEALS WORKFLOW
$0 up front — no minimum, no per-claim fee
Post-facto denial parsing and appeal drafting for clinical mismatches surfaced in existing systems.
- DENIAL PARSING & CLASSIFICATION
- APPEAL DRAFTING — AUTONOMOUS, AUDIT LOGGED
- PAYER RESPONSE ANALYSIS
- ACCESS-CONTROLLED AUDIT RECORDS
- ENCRYPTED IN TRANSIT AND AT REST
NORTHSTAR SOVEREIGN
DEDICATED MANAGED DEPLOYMENT
$0 up front — no minimum, no per-claim fee
A dedicated, customer-isolated managed deployment with encryption, access controls, and audit logging.
- CUSTOMER-ISOLATED DEPLOYMENT
- DEDICATED RESOURCE RESERVATION
- ROLE-BASED ACCESS CONTROL (RBAC)
- ENCRYPTED IN TRANSIT AND AT REST
- AUDIT LOGGED
Every module runs on the same commercial model: we keep 42.5% of the dollars we recover and you keep 57.5%. If we recover nothing, you pay nothing.
How you are charged
One line on your statement, and only when money is back in your account. We reconcile every ERA (X12 835) against the original claim, win back the denial, recover the underpayment, and take 42.5% of what lands. No subscriptions, no seat licences, no per-claim meter.
Charged only on recovered dollars — invoiced after the money clears.
Of dollars that were previously written off — pure upside, zero risk.
Payers, EHRs & Clearinghouses
Selling to insurers, or embedding our engine inside an EHR network, clearinghouse or legacy billing aggregator? We license the adjudication and FWA detection stack as an unbranded infrastructure layer at wholesale rates — you pay from the capital we protect.
- AI Pre-Submission Scrub — $0.35 / claim, wholesale
- AI Automated Appeal — $20 flat per appeal generated
- Unbranded or co-branded — runs inside your master system
What could you recover — and keep?
Move the sliders. Numbers update live.
Model assumes a blended $320 allowed amount per claim and a 55% net recovery on denied dollars. We keep 42.5% of what is recovered, you keep 57.5%. Illustrative only — your results depend on payer mix and specialty.