From paid claim to recovered dollar — in five steps.
Reclaim runs continuously. The moment your remits hit, the scan fires. The moment a claim is below contract, the flag goes up.
Connect your data
CSV upload, SFTP drop, or PMS/clearinghouse integration. We accept 837/835 EDI, ANSI flat files, or CSV exports from AdvancedMD, Tebra, WebPT, TherapyNotes, ChiroFusion, and Athena.
Continuous scan
Every paid claim is checked against the contracted rate from ReimburseOS — pulled live from the payer's most recent TiC MRF for the right NPI × CPT × payer × state combination. Sub-200ms per claim.
Underpayment flagged
Below contract → automatic flag. Reclaim records the shortfall, the contracted-rate evidence, and the most recent MRF effective date for the payer.
Queue to Denial OS
Flagged underpayment auto-creates an appeal in Denial OS with the contracted-rate paragraph pre-built. State prompt-payment statute attached. Letter generated by Opus 4.7. Faxed via Phaxio.
Recovered
Payer reprocesses. ERA returns the corrected amount. Reclaim closes the loop, marks the claim recovered, and ledgers the win to your YTD recovery total.