ClaimSleuth

ClaimSleuth is a web app (with optional mobile companion) that helps small and mid-sized outpatient clinics reduce insurance claim denials by catching common errors before submission. It connects to the clinic’s EHR/PM system via integrations, pulls draft claims, and runs rule-based checks plus lightweight AI suggestions on documentation completeness, coding mismatches, missing modifiers, eligibility conflicts, and payer-specific quirks. Instead of pretending to “solve billing,” it focuses on a narrow, measurable outcome: fewer avoidable denials and faster cash. Staff see a prioritized worklist, the exact reason a claim is risky, and a one-click checklist for what to fix. It also tracks denial reasons over time and highlights training gaps (e.g., one provider or procedure driving most issues). The product is designed for clinics that can’t afford enterprise RCM tools or full-time denial analysts.