Cleared extracts clinical data from your EHR, matches it against payer-specific coverage logic, and executes the submission through whatever channel the payer requires — then tracks it to resolution and auto-generates appeals on denial.
FHIR R4 and HL7v2 integration pulls structured clinical data from Epic, Oracle Health, and athenahealth. Medical NER parses unstructured notes — H&P, progress notes, operative reports — understanding clinical context, not just keywords.
A daily-crawled vector database holds live payer policy logic. RAG retrieves the exact policy language relevant to the case. A consistency check validates the clinical evidence against payer criteria before submission.
FHIR submission where payers support it. Browser agents for proprietary portals. Voice AI for payer hotlines. Digital fax for legacy payers. One submission, multiple fallback channels — the payer gets it their way.
Tracks every submission to resolution. On denial, the system retrieves the exact clinical gap, generates a structured appeal, and resubmits — without human intervention. Every denial improves the policy model.
The data flywheel is the architectural moat. Every denial contains a payer rule that didn't match the first submission. Cleared extracts that rule, encodes it, and propagates it to all customers on the next submission. Competitors maintain rule databases manually. Cleared learns from every interaction — automatically.
Built for CMS-0057-F compliance. FHIR APIs for payer submission, EHR integration, and interoperability out of the box.
Live payer policy retrieval against daily-updated payer coverage logic. Not static rules — dynamic retrieval grounded in current policy language.
Denial patterns become payer rules across the entire customer base. More customers = better coverage logic = higher approval rates for everyone.
Direct payer API submission where payers support it. CMS-0057-F mandates are forcing this open by January 2027 — we're ready on day one.
Browser agent navigates payer proprietary portals end-to-end. Structured data entry, attachment upload, status polling — without a human touching a screen.
Autonomous voice agent handles payer hotlines. Navigates phone trees, provides required information, escalates to reps, and captures disposition — at 2am if needed.
HIPAA-compliant digital fax for legacy payers still requiring fax submission. Automated cover sheet generation, confirmation tracking, retry logic.
We clear authorizations.
Not yours.