Benchify transforms healthcare contracts into executable logic to verify every transaction against formal rules. This platform enables payers and providers to ensure accurate payment settlement by catching errors in real-time, preventing leakage found in post-settlement audits. The system provides 100% transaction coverage with a fully auditable, traceable decision trail derived directly from contract language.
Funding
$500K raised to dateRaised to date based on public sources. This may differ from the amount the company actually raised and is based only on what is publicly available on the internet.
Founders
Product
Problem
Healthcare providers and payers frequently encounter claim denials, underpayments, and missing information due to misinterpretation or omission of payer contract terms. These errors are systematic, repeat across thousands of claims, and are hard to detect with traditional post‑pay audits.
Solution
Benchify transforms payer contracts into machine‑readable, executable logic that can be applied to each claim in real time. The platform predicts potential denials before submission, verifies every payment against the contract, and explains any discrepancies by linking them directly to the relevant contract clause. By modeling the full decision tree—from eligibility and network rules to rate escalators and modifier requirements—Benchify provides deterministic, traceable outcomes for each transaction, enabling providers and payers to recover lost revenue and avoid future errors without extensive integration projects.
Target Audience
Primary customers are hospitals, health systems, and payer organizations that manage large volumes of claims and need automated, contract‑driven revenue cycle validation.
Features
- Converts contract language into formal logic that can be executed against claim data automatically
- Pre‑submission prediction engine flags missing information and likely denials in seconds
- Post‑pay verification checks every payment for underpayment or wrongful denial, referencing the exact contract clause
- Explainability layer provides clause‑level evidence for each finding, supporting appeals and audits
- Supports full transaction coverage across 837/835 claim files via simple file upload or warehouse connection, compatible with major EHR systems
- Secure, BAA‑compliant infrastructure with audited controls for data confidentiality and availability