PreClaim
How PreClaim Is Delivered

PreClaim fits where you already work.

Your EHR doesn't change. Your workflow doesn't change. Your billing company doesn't change. PreClaim connects to what you have and runs underneath it — quietly assembling evidence, surfacing only what needs human attention.

Option A

Connect your EHR

Connecting PreClaim to your EHR works like connecting any app to your Google account — you click Connect, your EHR's authorization screen appears, you approve, and PreClaim has what it needs.

From that moment, PreClaim reads your appointment schedule automatically. For every upcoming visit, it runs the full evidence pipeline in the background. Your front desk coordinator sees a morning summary — green appointments that are ready, yellow ones with specific gaps and exact instructions, red ones that need action before proceeding.

Nothing to learn. No new login to remember. Evidence alerts appear where your staff already works — inside your EHR, or in PreClaim's dashboard as a guaranteed fallback.

Setup time:30 minutes· No IT team required
Compatible EHRs
NextGenathenahealtheClinicalWorksAdvancedMDDrChronoEpicCSV / Any EHR
Get Started — Free Audit
What your coordinator sees each morning
Johnson, R.64493 — ESI
Ready
94/100
Martinez, C.64635 — Facet
1 gap → imaging
71/100
Williams, T.64490 — Facet
Hold — missing PT notes
38/100
Chen, L.64483 — ESI
Ready
89/100

2 appointments ready. 1 needs one action. 1 needs coordinator attention.

How the workflow changes
Your billing workflow today
Visit happens
Claim submitted
Day 30: Denial received
Staff builds appeal
Day 60+: Maybe paid
With PreClaim embedded
Appointment scheduled → API call triggered
Evidence assembled automatically
Gaps flagged to your coordinators
Visit happens — evidence complete
Claim submitted — paid first pass
Option B

Through your billing company

If you outsource billing to an RCM firm or billing service, ask them about PreClaim. We integrate directly with billing company workflows via API — which means the pre-visit evidence work happens inside their process.

From your perspective, nothing changes. Your billing company just became proactive. Instead of calling you with denial appeals 30 days after the fact, they're now flagging evidence gaps before the visit. You see fewer denied claims. You don't see how it happens — because it happens in the background.

For practices:
Ask your billing company about PreClaim →
For billing companies:
Talk to Our Partnerships Team
Option C

For software platforms

If you build EHR software, practice management tools, or revenue cycle platforms, PreClaim's PolicyGraph API adds a payer intelligence layer to your existing product. Your developers integrate once. We maintain everything.

White-label ready. Your brand. Your UI. Our intelligence. Embed it in your scheduler, your authorization workflow, or your patient intake. Your users get pre-visit denial prevention. You get the feature without building it.

Request API Documentation
PolicyGraph API
// POST /v1/evidence/score
{
"patient_id": "pt_8821",
"cpt_code": "64493",
"payer_id": "noridian_je",
"dos": "2026-04-02"
}
// Response
{
"score": 71,
"status": "YELLOW",
"gaps": [
{ "item": "imaging_12mo", "action": "pull_hie" }
],
"pa_required": true,
"policy_version": "L39015-v8"
}

Which option is right for you?

Your EHRVia Billing CompanySoftware Platform
Setup time30 minutesBilling co. handlesDeveloper project
Who configures itYour staffYour billing companyYour dev team
Where results appearYour EHR + PreClaimBilling portalYour platform UI
White-label—AvailableAvailable
Best forDirect practice signupOutsourced billingHealth IT companies

PreClaim connects to any EHR that supports FHIR R4 APIs — which, as of 2024, is every certified EHR in the United States. Federal law requires it.

Don't see your EHR, payer, or market? Tell us — we prioritize by demand.

Ready to start?

The free DenialMap Audit works regardless of how you plan to access PreClaim. Start there — see the math — then choose how it fits your world.

Get Your Free Denial Audit