PayerProof

PayerProof is a web app (with optional EHR-embedded launch) that helps clinics produce audit-ready clinical documentation for prior auths, denials, and post-pay audits. It ingests encounter data (FHIR/HL7), attachments (PDFs, imaging reports), and payer policy rules, then generates a “proof packet” that maps each required element to the exact note section, timestamp, and source document. It flags missing medical-necessity statements, inconsistent diagnoses vs. orders, and weak plan-of-care language before claims go out. This is an AI + rules engine product: AI drafts suggested addenda and clinician-friendly prompts, while deterministic checklists enforce payer-specific requirements. Realistically, it won’t eliminate denials alone—payers change rules constantly—but it can materially reduce preventable documentation gaps and shorten appeal cycles by standardizing evidence packaging and traceability.