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Now available: AI-Powered Prior Authorization
Platform Overview

The Complete AI Revenue Cycle Platform

Six integrated modules powered by multi-model AI. From claim submission to revenue recovery, NexaClaim automates your entire revenue cycle with explainable, auditable intelligence.

How It All Connects

A continuous loop from claim ingestion to revenue recovery, powered by AI at every step.

Ingest

EDI 835 files, manual claims, and clearinghouse feeds flow into one unified pipeline.

Analyze

Multi-model AI identifies root causes, scores recovery probability, and detects coding gaps.

Act

Generate appeal letters, correct codes, and submit prior authorizations automatically.

Recover

Track outcomes, measure AI impact, and continuously improve your revenue cycle.

Works With Your Existing Stack

NexaClaim integrates with major clearinghouses, EHR systems, and payer portals. No rip-and-replace required.

Availity
Change Healthcare
Waystar
Trizetto
Epic (FHIR R4)
Cerner (FHIR R4)
athenahealth
eClinicalWorks

V1 supports EDI 835 file upload. Direct API integrations and FHIR R4 connectors available in Phase 2.

Built on Enterprise-Grade AI

Multi-model intelligence, transparent reasoning, and healthcare-grade security from the ground up.

Multi-Model AI

GPT-4o for clinical NLP, Claude for appeal writing, and specialized models for classification. Automatic fallback ensures uptime.

Explainable Decisions

Every AI suggestion includes evidence spans, confidence scores, and reasoning chains. No black-box outputs.

HIPAA Compliant

End-to-end encryption, row-level security, PHI redaction in logs, signed BAAs with every vendor, and immutable audit trails.

Continuous Learning

Aggregated, anonymized payer data across the network creates a compounding intelligence advantage that improves every customer.

Ready to Transform Your Revenue Cycle?

See how NexaClaim AI can reduce denials, accelerate collections, and recover lost revenue for your organization.