Real-Time Claims Validation & Intelligent Clearinghouse

THE C.U.R.E.

Communication Unlocked in Real-time Ecosystem

Validates every claim before submission. Eliminates denials. Under 50 milliseconds.

Made by: Bert Rendon

The Healthcare Payment Crisis

0
+ Days
Average claim denial response
$262B
Annual cost of claim denials in the US
0
%
Claims denied on first submission

The current system is broken. Providers submit claims blindly, wait weeks for responses, and lose revenue to preventable denials.

THE C.U.R.E. Changes Everything

TODAY

ProviderClearinghousePayer

Errors → Delays → Denials → Appeals

VS

WITH THE C.U.R.E.

Provider + THE C.U.R.E.Payer

Validated → Approved → Paid

7-Step Validation Pipeline

Under 50 milliseconds. 99% invisible. 1% minimal intervention.

1
PHI Validation
SHA-256 hash, scrub, mask
2
Medical Necessity
ICD-10 vs CPT alignment
3
Policy Rules
Query insurer via bridge
4
Eligibility
EDI 270/271 verification
5
Prior Auth
EDI 278 if required
6
Payment Calc
MPFS: RVU × GPCI × CF
7
Decision
APPROVE / DENY / INTERVENE

Value Impact for Hospitals

$

Savings on Clearinghouse Fees

A mid-size hospital submitting 100,000 claims/year saves $25,000–$150,000 annually in clearinghouse fees alone.

Fewer Denials, Less Rework

Pre-validate every claim before submission. Catch errors, coverage gaps, and medical necessity issues in real-time.

Faster Payments

From 30+ day denial cycles to real-time validation. Claims arrive at payers already validated and ready to pay.

Built for Epic. Ready for Everyone.

PLUGIN Mode

Runs invisibly inside Epic. Your EHR sends claims via API, we validate and return results. Lightweight JavaScript modal for the rare intervention. Zero workflow disruption.

STANDALONE Mode

Full admin dashboard, visual pipeline, intervention management. For direct deployments, demos, and organizations outside Epic.

Supports FHIR R4 (11 resource types), EDI X12 5010 (13 transaction types), 4 payment file formats (NACHA, ISO 20022, EDI 820, JSON).

Enterprise-Grade Compliance

HIPAA Privacy Rule
HIPAA Security Rule
HIPAA EDI Standards
21 CFR Part 11
CMS-0057-F (FHIR)
US Patent #64/026,459

SHA-256 hash-chained audit trails. Immutable records. 7 PostgreSQL triggers physically prevent modification. Even a database administrator cannot alter records.

0
Tests Passing
0
Medical Codes
0
Database Tables
0
API Endpoints

Ready to See THE C.U.R.E. in Action?