Sandiola provides AI-powered clinical documentation integrity (CDI) services exclusively for community hospitals and health systems, combining a proprietary AI system called Sandpiper with dual-credentialed CDI and coding experts. The company reviews every DRG-reimbursed case to capture patient acuity, secure full reimbursement, and defend against payer denials, operating on a contingency fee basis with a money-back guarantee. Sandiola reports an average of $1,046K in annual recaptured revenue per 3,000 inpatient discharges, with implementation completed in 30 days.
Funding
Funding not disclosed
Founders
Product
Problem
Community hospitals systematically undercode their own clinical complexity, losing an estimated 3-7% of net patient revenue annually to coding and documentation gaps. Roughly 37% of Medicare cases miss a documented complication or comorbidity that could change the DRG, and sepsis cases frequently lack MCC documentation despite clear clinical evidence, leaving significant reimbursement on the table.
Solution
Sandiola provides an AI-powered clinical documentation integrity platform built exclusively for community hospitals and health systems. The company's compound AI system, Sandpiper, reviews every chart in under a second and surfaces the highest-yield cases first, while dual-credentialed CDI and coding clinicians review every DRG-reimbursed case. Sandpiper generates DRG recommendations with full clinical reasoning, enabling CDI teams to confidently confirm changes and learn from each recommendation. The service operates on a contingency fee model with a money-back guarantee: if a payer denies a recommendation, Sandiola fights the appeal at its own cost, and if it still doesn't hold, the fee is refunded.
Target Audience
Primary customers are community hospitals and independent health systems with limited CDI resources, including rural hospitals that rely on Sandiola as their dedicated CDI experts.
Features
- Sandpiper AI reviews 100% of charts in under one second, prioritizing cases by reimbursement yield
- Dual-credentialed clinicians (CDI and coding) provide expert review of every DRG-reimbursed case
- Every DRG recommendation includes full clinical reasoning for reviewer confidence and workforce upskilling
- Pre-bill and post-bill workflows with physician query support and real-time coaching
- Money-back guarantee against payer denials and downgrades, with appeal support at Sandiola's cost
- 30-day implementation timeline from contract signing to go-live