Claritas pairs deep RCM expertise with clinical AI to fix problems where they start — in the chart, the code, and the edit. The result: cleaner claims, faster cash, and calmer teams.
Pre-bill review
Encounter cleared in 168ms
Multi-specialty rule packs, EMR integration, and governance your compliance team will love.
Right-sized automation that lets a lean billing team punch well above its weight.
Multi-tenant configuration, white-label dashboards, and per-client rule libraries.
Documentation lives in the EMR. Codes live in the encoder. Edits live in the clearinghouse. Denials come back days later — and your team spends nights stitching it all together. Claritas closes the gaps with one decisioning layer that sees the whole picture.
1 in 5
claims is denied on first submission
14 days
average lift to A/R from preventable errors
$118
industry cost to rework a single denied claim
We sit quietly in the middle of your revenue cycle, scoring encounters and claims as they pass through. Most flow straight through. The few that need attention reach the right human, with the right context, at the right time.
Surface coding and documentation gaps while the encounter is still fresh.
Send only the work that needs human judgement to your coders and billers.
Three modules, one workspace, one audit trail. No swivel-chair.
Rule packs adapt as payer policies and your own denial patterns evolve.
Throughput
3×
faster pre-bill review
Encounters move through coding and edits in minutes — not days — with intelligent triage.
Yield
+11%
lift in net collections
Catch under-coding, missing modifiers, and payer-specific gaps before claims ever leave your shop.
Quality
−42%
denial rate over 6 months
Continuously tuned rules learn from your payer mix and stop the same denial from happening twice.
Lumen Pre-Bill, Risk Lens HCC, and Sentinel Edits work as one — sharing rules, signals, and learnings — so your team gets a single, coherent view of every encounter and every claim.
Pre-bill intelligence
Catch the issue before the claim is born.
A clinical + financial review layer that sits between your EMR and your billing system, flagging coding gaps, eligibility risks, and documentation issues at the source.
Learn moreRisk-adjustment coding
Close every HCC gap, defensibly.
Reviews encounters in near real-time, surfaces suspect conditions with chart evidence, and routes only what truly needs a coder — everything else flows automatically.
Learn moreDenial prevention engine
Stop denials before they ship.
A configurable scrubber tuned to your payers, specialties, and historical denial patterns — with edits you can read, audit, and trust.
Learn more"Within one quarter our first-pass yield climbed double digits and our coders finally had room to breathe. Claritas is a partner, not a tool."
Dr. Rohan Mehta
VP Revenue Operations, Northstar Health Systems
"Arpita's team understood our payer mix faster than any vendor we've worked with. They built rule packs around our reality, not a generic playbook."
Priya Krishnan
Director of Billing, Meridian Physician Group
"We compared four platforms. Claritas won on transparency, accuracy, and the depth of the people behind it."
Marcus O'Connell
COO, BrightPath Billing Services
"Risk Lens surfaces HCCs our coders were missing — with chart evidence attached. RAF is up, audit risk is down, providers are happier."
Dr. Sara Whitfield
Chief Medical Officer, Cascade Primary Care
No giant kickoffs. No 12-month roadmaps. We start narrow, prove the lift, and scale from there.
01
Discovery call
A 30-minute working session to understand your stack, payer mix, and biggest revenue leaks.
02
Tailored pilot
We configure Claritas around your specialties and historical denials — and prove value on a defined cohort.
03
Scale with us
Roll out across the enterprise with a delivery team that's owned RCM operations themselves.
Bring a sample of denials or encounters — we'll show you exactly where the leaks are, and what we'd do about it.