InvisaClaim
InvisaClaim is the most advanced all in one revenue platform. An AI-powered Revenue Cycle Management platform that automates denial management, appeals, prior authorizations, and No Surprises Act compliance for billing companies and RCM teams.
Upload or Live Feed a denial letter or 835 ERA and AI extracts patient data, CARC/RARC codes, CPT/ICD-10, amounts, and deadlines, then generates payer-specific appeal letters in 60 seconds across 30+ payers.
Modules: Denial Workbench, NSA/IDR (eligibility checks, QPA capture, GFE & IDR letters), Prior Authorization, Pre-Check AI, A/R aging, NPPES NPI verification, deadline alerts, and full audit trail.
Connects directly to your clearinghouse and EHR. Integration partners: Change Healthcare/Optum (ERA, eligibility, claim status, prior auth), Availity (in progress), Waystar (Provider Access Request). EHR partnerships with Athenahealth in the marketplace pipeline, plus a FHIR R4 layer for Epic/Cerner.
HIPAA Compliant, SOC2 & 25k
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Paradigm
Paradigm Senior Services offers a full-service, AI-powered revenue cycle management platform specifically tailored to home-care agencies that bill third-party payers such as the U.S. Department of Veterans Affairs (VA), Medicaid, and other managed-care payers. It automates and streamlines every step of the billing and claims process: from eligibility/authorization verification, state- or payer-specific enrollment and credentialing, to submission of clean claims, denial handling, and payment reconciliation. It integrates with common agency management software and electronic visit verification tools to scrub shifts, verify authorizations weekly, and reconcile payments, reducing denials and minimizing administrative burden. Paradigm also supports “back-office as a service” for providers; even if they already have internal billing staff or scheduling software, Paradigm can take over claims processing as a specialized, expert billing department.
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ABN Assistant
For providers, medical necessity denials cost thousands to millions of dollars every year in write-offs, plus costly staff time researching and appealing denials and responding to patient concerns. For payers, the same is true on the other end of the claim management spectrum: Paying for medically unnecessary procedures and treatments – and time spent working on denial appeals – raises costs without improving outcomes. And of course, for the patient, there can be unnecessary copays and other out-of-pocket costs, not to mention a poor patient experience involving costs and moments of care they did not need. ABN Assistant™ from Vālenz® Assurance delivers the prior authorization tools providers need to validate medical necessity, print Medicare-compliant ABNs with estimated cost, and stop over 90 percent of medical necessity denials by verifying necessity before care is delivered to the patient.
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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.
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