Six modules that put money back in the claim.
NorthStar Claim sits in front of your billing workflow. It catches the errors that cause denials before submission, decodes the denials that still land, and writes the appeal that gets the money back. You pay per claim — from $1.00 down to $0.50 as volume grows.
- Priced per claim
- $0.50–$1.00
- No upfront licence fee
- First appeal
- Free
- Then $39 or 12% contingency
- PHI stored
- None
- Processed in memory, not persisted
The modules
Each one runs on the same claim record, so a fix in one place is visible everywhere.
Pre-submission claim scrubbing
Every X12 837 claim is checked against payer-specific edits before it leaves your building — coding pairs, modifiers, POS, eligibility, timely filing and coverage rules. Errors are flagged with the exact field to fix.
- Payer-specific edit packs
- NCCI / bundling checks
- Modifier and unit validation
Denial prediction & risk scoring
Each claim gets a denial-risk score with the reasons behind it, so your team works the risky 10% instead of re-reading the clean 90%. The model learns from every remittance you receive.
- Per-claim risk score
- Ranked likely denial reason
- Learns from your own 835 history
ICD-10 / CPT auto-coding
The clinical note is read and the correct ICD-10 and CPT/HCPCS codes are proposed, with the documentation that supports each one surfaced alongside. A coder approves before anything is submitted.
- ICD-10-CM / PCS + CPT / HCPCS
- Evidence links back to the note
- Human-in-the-loop review
Autonomous denial prevention
A payer rule engine holds back claims that would fail on submission and routes them for correction — so the denial never happens and the rework cost never lands on your team.
- Payor policy rule packs
- Auto-hold + fix queue
- Audit trail on every decision
AI denial appeals
Paste a denial letter or code and get a payer-ready appeal with the coding justification, medical-necessity argument and the correct legal framework (ERISA § 503, prompt-payment statutes) cited.
- First appeal drafted in seconds
- Medical-necessity + legal basis
- Copy, download or file
ERA reconciliation & underpayments
835 remittances are posted and matched against what you expected. Short pays, silent-PPO reductions and unbundled line items are caught and queued for follow-up rather than written off.
- 835 auto-posting
- Contract vs paid variance
- Underpayment worklist
Overlay, don't replace.
You keep your EHR, your clearinghouse and your billing team. NorthStar Claim reads the standards your systems already speak and writes back only what a human has approved — so there is no migration project and no downtime.
Built for PHI from day one
- HIPAA-aligned controls with a Business Associate Agreement (BAA) on every paid plan.
- Clinical text is processed in memory to produce an output and is not persisted as a patient record.
- Encrypted in transit and at rest; access is scoped to your organisation.
- Every automated decision is logged with the model version and the input that produced it.
See what your own claims would have caught.
Upload a batch of claims and we'll show you the errors, the projected denials and the recoverable dollars — before you commit to anything.