Ambra911’s Resolve platform automates the denial‑to‑appeal process for EMS and medical transport providers by extracting clinical evidence from patient care reports and generating payer‑ready appeal packages in seconds. It continuously monitors open appeals, flags missed statutory deadlines, and automatically creates compliance affidavits or Department of Labor complaints, while integrating via standard EMS data formats and X12 EDI without replacing existing billing systems.
Funding
Funding not disclosed
Founders
Product
Problem
Medical transport providers often face delayed and costly revenue cycles due to payer denials, complex appeal processes, and missed statutory deadlines, leading to lost reimbursements and increased administrative burden.
Solution
Ambra Resolve automates the denial-to-appeal workflow by reading patient care reports, extracting clinical evidence, and generating payer‑ready appeal packages in seconds. The platform continuously monitors open appeals, cross‑references state regulations, and automatically prepares compliance affidavits or Department of Labor complaints when deadlines are missed. Integration is achieved through standard EMS data formats and X12 EDI, allowing Resolve to sit atop existing PCR, CAD, and clearinghouse systems without requiring a rip‑and‑replace. By prioritizing high‑value claims and accelerating resolution, the solution reduces average denial resolution time from 42 days to 4 days, cuts rework costs, and can increase net revenue by roughly 10% for midsize agencies.
Target Audience
Ambra Resolve is designed for emergency medical services (EMS) agencies, medical transport companies, and their revenue cycle management teams that handle large volumes of transport claims and denials.
Features
- AI‑driven extraction of clinical evidence from patient care reports to create complete, payer‑ready appeal packages
- Real‑time monitoring of appeal windows with automatic generation of compliance affidavits and statutory filings
- Seamless integration using standard EMS data formats and X12 EDI, requiring no changes to existing billing infrastructure
- Prioritization engine that scores stale denials by recoverability and queues highest‑value claims first
- Automated escalation workflow for rejected appeals, including peer‑review, state complaints, and DMHC/CMS filings
- HIPAA‑compliant security with 256‑bit encryption for data in transit and at rest