Cair Health provides an AI‑driven platform that automates revenue cycle management for medical practices and health systems. Its large‑language‑model agents handle claim creation, denial resolution, underpayment detection, and compliance monitoring, generating first‑pass‑ready 837 files and appeal documents while integrating securely with EHRs, X12 EDI, and FHIR. The solution is HIPAA and SOC 2 compliant, does not store or train on client data, and is delivered via a subscription model.
Funding
Funding not disclosed
Founders
Product
Problem
Healthcare providers often struggle with slow, error‑prone revenue cycle processes, leading to claim denials, underpayments, and delayed cash flow. Manual coding, eligibility checks, and denial management consume staff time and increase the risk of compliance breaches.
Solution
Cair Health offers an AI‑driven platform that automates key revenue cycle tasks using specialized large language model agents. The claim‑processing agent reviews clinical notes, payer policies, eligibility data, and coding rules to generate compliant, first‑pass‑ready claims. A separate denial‑management agent retrieves electronic remittance advices, analyzes denial reasons, and creates revised 837 submissions, even contacting payers when needed. Additional agents monitor contracts and historical data to detect underpayments and prevent revenue leakage. All data is synchronized via secure APIs supporting EHRs, X12 EDI, and FHIR, and the platform maintains HIPAA and SOC 2 compliance without storing or training on client data.
Target Audience
Primary customers are small to large medical practices and health systems seeking to streamline revenue cycle operations and improve cash flow.
Features
- AI agents for claim creation, denial resolution, underpayment detection, and compliance monitoring
- Real‑time integration with EHRs, clearinghouses, and payer systems via APIs, X12 EDI, or FHIR
- Automated generation of compliant 837 claim files and appeal documents
- Continuous monitoring of payer contracts and historical claims to identify revenue leakage
- Secure, HIPAA‑ and SOC 2‑compliant architecture that does not store or train on client data
- Scalable plans offering multi‑state, multi‑EHR, and custom AI agent capabilities