Jaguar & Fern offers a plug‑and‑play routing engine that integrates directly with existing EHR and prior‑authorization workflows to automatically screen each case against the appropriate site of care before a claim is filed. By applying objective CMS standards in real time, the platform helps health systems and payers prevent denials and protect margins without extensive implementation effort. The solution is built on HIPAA‑compliant, AWS‑hosted infrastructure and includes real‑time reporting and documented outcomes.
Funding
Funding not disclosed
Founders
Product
Problem
Health systems and payers frequently route surgical cases to inappropriate facilities, leading to lost margins for providers and overpayments for insurers. Mis‑sited claims often result in downstream denials that disrupt revenue cycles, and the necessary data to correct these errors resides within existing EHR and prior‑authorization systems.
Solution
Jaguar & Fern offers a plug‑and‑play routing engine that integrates directly with an organization’s EHR or prior‑authorization workflow. The engine automatically applies federally defined CMS site‑of‑care criteria to each surgical case, determining the most cost‑effective facility before the claim is submitted. By routing cases correctly at the point of care, the platform prevents margin loss and reduces the likelihood of claim denials. The solution runs on HIPAA‑compliant, AWS‑hosted infrastructure with SOC 2 certification in progress, providing real‑time reporting and documented outcomes from the first processed case. This enables health systems and payers to capture recoverable margin without extensive implementation effort.
Target Audience
Primary customers are health system surgical departments and payer networks that manage large volumes of surgical referrals and need to optimize site‑of‑care placement to protect margins and reduce denial rates.
Features
- Seamless integration with existing EHR and prior‑authorization systems via a pre‑built routing module
- Automatic application of objective CMS site‑of‑care standards to every surgical case
- Real‑time routing decisions that occur before claim submission
- Immediate reporting dashboard showing routing outcomes, margin impact, and denial avoidance metrics
- HIPAA‑compliant, BAA‑ready cloud architecture hosted on AWS with SOC 2 certification underway
- Documentation of each routing decision to support audit and compliance requirements