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Eye care · insurance · HIPAA

ClaimStride

Liveat an eye clinic

Asks every insurer where each unpaid claim stands and writes the next step, for eye care and dental.

1,140 claims

read from the biller's real report, every total matching hers

About 2 min

to get insurer status on 97 unpaid claims in AR

The biller's first live run, on her real claims.

The ClaimStride board sorting a sample clinic's unpaid claims by what needs action
Claims sorted by what needs action.

How it works

  1. Read the claims report

    ClaimStride reads the claims report the practice already exports, every format and every sheet. Nothing plugs into the practice software.

  2. Ask every insurer

    Every unpaid claim goes to its insurer in one run, through a healthcare clearinghouse, and comes back with a clear status.

    The ClaimStride board sorting a sample clinic's unpaid claims by what needs action

  3. Sort by what's needed

    Claims are sorted by what they need: denials grouped by reason and age, and the nearest filing deadlines first.

  4. Write the next step

    Each claim gets its next step in plain words, with numbered steps and the timely filing deadline, so the biller knows what to fix and by when.

What I built

Reads their own report

It works from the claims report the practice already exports, in every format and every sheet, at the eye clinic and the dental office. Nothing has to plug into the practice software.

Asks every insurer

Each unpaid claim goes to its insurer through a healthcare clearinghouse and comes back with one clear status: needs action, paid, pending, or not on file.

A next step on every claim

Where the insurer or its payment file gives a reason, ClaimStride writes it in plain words, with numbered steps and the timely filing deadline, so the biller knows what to fix and by when.

The board the biller asked for

Primary, secondary and tertiary claims kept apart, denials sorted by reason and age, and the nearest deadlines first. The cost shows before every run, with a monthly limit.

The denials list for a sample clinic, filtered by how each claim was denied, with one denied claim opened
Denials, sorted by reason.
A denied sample claim opened with the reason in plain words, numbered steps and the appeal deadline
A denial's steps and deadline.
BeforeAfter Why a claim hasn't paidA portal or a call per claimAsked of every insurer in one run
In their words

“This all reads very accurate… it really truly gives you everything that you would need at a quick glance.”

The biller, Wichita Family Vision

Engineering

Exported reports instead of a vendor integration, so it runs on day one. No electronic answer means a call, never a guess.

How it fits together
A FastAPI service. Plain code parses the report and every X12 answer; Claude on Bedrock reads scanned EOBs. Same claim, same status.
Tested
2,596 automated tests.
Cost to run
About 30 cents a check.
Runs on
The clinic's own AWS account, under its BAA.

My role. My co-founder built the first version. I rebuilt how it reads insurer answers and built the eye care side.

Previous buildPharmacy lead finderDelivered Next buildComputer-use agentsPassing practice runs
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