Question 1

What does NorthStar Claim do?

Accepted Answer

NorthStar Claim is an AI revenue-recovery platform for healthcare providers. It scrubs every claim before submission, predicts which claims a payer will deny, auto-codes ICD-10 and CPT from the clinical record, and drafts payer-ready appeal letters for denials that still occur.

Question 2

How much does NorthStar Claim cost?

Accepted Answer

Nothing up front. NorthStar Claim works on contingency: we retain 42.5% of the denied, underpaid or downcoded dollars we recover on your behalf, and you keep the other 57.5%. There is no per-claim fee, no monthly minimum and no licence fee. Payers, EHR networks and clearinghouses that embed the engine license it wholesale (per-claim AI scrub + a flat fee per automated appeal).

Question 3

Do we have to replace our EHR or billing system?

Accepted Answer

No. NorthStar Claim sits alongside your existing EHR and clearinghouse. We ingest claims in X12 837 format, scrub them, and return a corrected payload or a denial-risk score. Your systems and workflow stay in place.

Question 4

How does the AI denial appeal feature work?

Accepted Answer

You paste the denial and the clinical context, and NorthStar Claim extracts the billing facts, builds the medical-necessity argument, cites the payer's legal obligation, and drafts a structured appeal letter ready to send — in seconds.

Question 5

Is NorthStar Claim HIPAA compliant?

Accepted Answer

Yes. Protected health information is processed transiently to perform claim work and is not retained after transmission to the clearinghouse. We operate a HIPAA-aligned architecture, sign a Business Associate Agreement (BAA) with every customer, encrypt data in transit and at rest, and maintain an audit log of access.

Recovery
Resources

The ERISA Advantage: How to Force Insurance Settlements

Autonomous RCM: Why Traditional Billers are Failing

CMS Compliance Roadmap: 2026 Regulatory Update

X12 837P Validation: Automating Claims Integrity

HL7 to X12: Real-Time Translation Architecture

Stay Briefed on the Grid

Recovery Resources