Sudoboat / Industries / Healthcare & Revenue Cycle
INDUSTRY · HEALTHCARE & REVENUE CYCLE

Appeals at payer speed,
more recovered revenue.

Payers use automation to deny thousands of claims instantly — while most provider teams still work appeals one at a time, by hand. We build AI agents that read the denial rationale against payer policy and prepare appeals at scale. Recovered revenue is measurable per claim.

02 · WHAT IT IS
The asymmetry

The side automating the decision keeps the margin — and right now it's the payer.

The payer's "no" is instant, machine-generated and at scale. The provider's appeal is still assembled by hand, one claim at a time — excellent work, human-paced, against a machine-paced denial engine. Every appeal your team doesn't get to is revenue written off, and it compounds with missed follow-ups and filing deadlines.

The fix isn't more billers. Our agents take the mechanical 70% of denial work off your team — code reading, triage by recoverable value, deadline tracking, first-draft assembly — while the clinical appeal decision stays with your people. The team you already have works the dollars that matter, at machine pace. The same triage-by-value pattern runs in general insurance, where our agents handle AI claims triage and FNOL intake.

03 · WHAT WE BUILD
What we build · revenue cycle

Denials worked end-to-end — read, ranked, drafted, tracked.

01 · TRIAGE

Denial triage by dollars

Every denial scored by recoverable value × winnability the moment the 835/ERA lands — worked by what it's worth, not by what clears easiest.

835/ERACARC/RARCValue-ranked
02 · APPEAL

Appeal assembly at scale

Clinical docs pulled and matched to the payer policy in force, the appeal drafted for review — hours of skilled hunting per appeal, done by the agent.

Policy in forceDraftedYour sign-off
03 · CLOCK

Filing-deadline clock

A deterministic clock runs every filing window and escalates before anything ages out — the most expensive leak is the most mechanical, and it goes to zero.

Every windowEscalatesNo write-offs
04 · UPSTREAM

Eligibility & charge capture

Once denials run at machine pace: eligibility checks and charge-capture review on the same pipeline, closing leaks before they become denials.

EligibilityCharge captureCoding next
04 · CAPABILITIES
Beyond the revenue cycle

The same system, across clinical and pharma ops.

Patient helplines with clean human hand-off, document AI over regulatory and clinical records, pharmacovigilance triage, disease and supply anomaly detection — built to the same clinical-safety and audit bar.

05 · DELIVERY
Delivered through

The same 5-stage system we run everywhere.

Discovery to scale, engineered for production from day one.

See how we deliver →
01
Discover
02
Design
03
Build
04
Deploy
05
Scale
Start with the teardown

See where your revenue cycle leaks dollars.

A short, no-pitch teardown: the five places revenue leaks before an appeal is even filed, and which of them AI actually closes. Then, if it's worth a conversation, a 20-minute look at your denial flow.

Get the revenue-cycle teardown → Book a discovery call