Wrap payment reconciliation
Visit by visit, was the plan billed, did the plan pay, was the wrap billed, and did the state pay. Unmatched visits become a recovery worklist.
Healthcare
We help healthcare finance and revenue-cycle teams close the gap between data and action.
That can mean finding issues in claims, billing, remits, payer reports, or clinical data - and then helping clean them up, document them, follow up, and get them resolved.
Start with one revenue or coverage workflow.
Denials and remits
Parse every remit and denial, flag what's appealable, and prepare appeal-ready drafts.
Quality-program credit
Find care that happened but never got counted because it is documented in the chart and missing from the claims.
Coverage-renewal risk
New Medi-Cal work-reporting and six-month-renewal rules take effect in 2027. We help identify patients most likely to lose coverage for paperwork reasons, and cases where claims data may not yet prove an exemption the chart supports.
Evidence packets
Assemble claims, codes, notes, payer files, source rows, and missing proof for human review.
Patient-level worklists with the proof attached.
Each row should tell your team what is at stake, why it was flagged, which source supports it, what is missing, who owns the next step, and what action is recommended.
Human reviewers make every determination. Caseline assembles the evidence.
The work product shows what's missing, what's stuck, and what's ready for review.
Start with read-only extracts and a narrow question.
1
Pick one workflow
Payment variance, wrap recovery, denials, quality credit, or coverage risk.
2
Send read-only files
Send reports, extracts, or a queue under the right confidentiality terms.
3
Review the output
Caseline maps the sources, reconciles the data, and prepares a reviewed worklist.
4
Decide what runs monthly
Your team audits rows before deciding whether to run the workflow monthly.
Built for sensitive healthcare and claims data.
BAA available, no customer data used for model training, audit trail, and single-tenant deployment available.
Have one healthcare workflow worth testing?
Read-only extracts, roughly 30 days, and receipts on every row.