AI-powered medical claims recovery for self-insured employers
We help employers and health plan administrators recover millions in overpaid medical claims. Fast, independent validation with zero operational burden.
The healthcare system is complex—and billing errors are costing you more than you think.
of Medicare claims contain errors. Commercial plans see similar rates. That's millions in overpayments walking out your door.
months for traditional recovery audits. By then, the money—and the opportunity—is gone.
EDI formats are complex. Your team doesn't have time to become EDI experts.
Three steps to recovered revenue
We receive your 835/837 EDI files via secure SFTP or encrypted upload. No IT integration required.
Our AI parses every claim against 300+ validation rules. Human auditors review flagged items.
Receive a detailed recovery report in days, not months. We provide the path to recover every dollar.
See how much you could recover with a quick audit
Based on 50% of errors being recoverable
Based on 3-9% industry error rates
Total value of billing errors
Purpose-built for your specific needs
50-500+ employees managing their own health plan. You pay the claims—you should know they're right.
Third-Party Administrators who want independent validation to ensure accuracy and build client trust.
Organizations managing multiple employer plans who need scalable, accurate claims validation.
What makes us different
Findings in days, not months. We know overpayments lose value over time.
Machine learning + human expertise. We catch what automated systems miss.
No IT integration. We handle the EDI complexity. You get clear findings.
We only get paid when you recover money. No upfront fees. No risk.
Schedule a free claims audit. See exactly what's recoverable—no obligation, no upfront cost.
Include your company name, number of covered lives, and annual health spend for a quick estimate.
Fill Out Our Contact Form →Your data security is our highest priority
ClaimsGuard.io operates as a Business Associate under HIPAA regulations. We understand that medical claims data contains Protected Health Information (PHI) and treat it with the highest level of security and confidentiality.
All client data is protected with AES-256 encryption at rest and TLS 1.3 in transit. Your data is unreadable without proper authorization.
We provide Business Associate Agreements (BAAs) to all clients. This legally binds us to HIPAA compliance and specifies our responsibilities.
Your data never touches third-party clouds. We maintain full control over our infrastructure and data handling processes.
Role-based access with multi-factor authentication.
Complete logging of all data access and modifications.
Data retained only as necessary, then securely deleted.
24-hour breach notification procedures.
Annual HIPAA training for all team members.
Secure facilities with controlled access.
We're happy to discuss our security practices and provide our BAA for review.