Meet Sofie, your revenue cycle AI, inside your network.
We build and run the data platform between your EHR and your general ledger: eligibility verification, EDI integration, payment reconciliation, and on‑premises AI. Every pipeline is engineered, documented, and operated in the United States.
Each service below is a system we have taken from design to daily production operation for healthcare providers, not a capability on a slide.
Automated coverage checks against Medicaid / Medi‑Cal (270/271) and commercial payers, batch and on demand, with results written back to your systems and routed to the right inbox. Thousands of checks a day, rules the billing team can change without touching code.
Parsing and warehousing of X12 835, 837, 277, and 999 files so every claim, payment, and denial is a queryable row, tied to its batch and its remittance, instead of a PDF in a folder.
Daily journal entries generated from EHR billing activity and imported into your ERP by API, NetSuite included, with team reports delivered every morning. Tens of thousands of claims a month, reconciled to the penny.
Your ledger matched against payer remittance files line by line, every difference classified into a working category, and worklists your billing team can act on the same day.
Plain‑language explanations of remittances and denials, question‑and‑answer over your approved data, and document understanding, running on hardware inside your network, so no client data ever leaves your building.
Scheduled pipelines and supervised browser automation for payer portals and systems without APIs, turning repetitive data entry into a reviewed, logged, repeatable job.
For behavioral health organizations on Netsmart myAvatar, the automation reads billing activity from myAvatar and runs each lane on its own schedule: eligibility to the state Medicaid payer, claims into your ERP, reconciliation worklists, and an AI denial explainer that runs on a local AI server.
All work is performed in the United States, by us, on your systems, under a Business Associate Agreement. That sentence is our architecture, not a policy aspiration.
We build on‑premises first: your data stays in your network, every automated action runs under a dedicated, auditable service account, and credentials live in your vault, not in our scripts. This posture is written to satisfy the strictest reading of county, Medicaid, and SSA data requirements, the ones a standard BAA alone does not cover.
From full operation of your platform to a single build.
| Model | What it covers | Fits when |
|---|---|---|
| Managed platform | We operate your pipelines daily with committed response times, second‑line support behind your team, continued development, and a monthly written status report. | The platform is in production and the business depends on it. |
| Project build | A defined system, eligibility automation, an ERP integration, a reconciliation, delivered documented and running, with your team trained to operate it. | You know what you need and want it built right once. |
| On demand | Hourly engineering, scheduled within days of request, no monthly commitment. | Occasional needs, or a first small engagement to evaluate us. |
Thirty minutes is enough to tell you whether we can help, what it would look like, and what it would cost. If we are not the right fit, we will say so in the same call.
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