INCISE AI — Surgical Revenue Intelligence

Measured, Not Promised

The engine is already running in live production

The platform technology powering INCISE AI operates in production today. These are measured results — not projections.

92.5%

Referrals handled end-to-end

Inbound referral faxes captured, structured, and processed with no human touch.

90.6%

Processed within 24 hours

Around the clock — the first practice to respond wins the patient.

$865K

Stuck AR surfaced

Collectible cash identified in aged receivables, ranked and worked.

$289K

Underpayments quantified

Payer underpayments identified and documented for appeal.

Measured June 2026 in a live production deployment of the licensed platform technology at a Texas healthcare operation; methodology available on request. Results reflect that deployment's volume and payer mix — your revenue analysis models yours.

The Problem

The money isn't lost in your front office or your back office.
It's lost between them.

A referral becomes a patient becomes a claim becomes a payment — and every manual handoff along that line is where your margin goes. Legacy billers answer with people, then charge a percentage of everything you collect to cover them.

$120K–$300K lost annually

What a typical surgical group leaves behind with a generalist biller — missed modifiers, coding leakage, denials worked late or never.

8–12% first-pass denials

The industry norm for surgical claims. Most are pattern errors software should have caught before the claim ever left.

⏱

60–120 days to cash on disputes

Out-of-network claims without disciplined federal-arbitration operations — the money is real, and perpetually late.

Written-off backlog

Old denied and unbilled claims your current biller gave up on. Much of it is still recoverable — through the right process.

One Pipeline

Referral to resolution — one system owns the whole line

Integrated with your EHR and clearinghouse. Your front office keeps the wheel; the platform does the work.

Referral Intake

eFax, email, and electronic referrals captured and structured automatically — no re-keying, no queue.

Benefits & Eligibility

Coverage, eligibility, and authorization verified at intake — problems caught pre-op, not post-denial.

Appointment Booked

Scheduling triggered from the cleared referral.

Care Team & Patient Comms

Both sides informed automatically — HIPAA-compliant, consent-tracked.

AI Coding Check

Surgical CPT logic and modifier rules applied to every charge before it becomes a claim.

Claims Drop

Clean claims direct to the clearinghouse — hours, not days.

Adjudication Tracking

Status polled continuously. Nobody waits on payer mail.

Ops · Finance · RCM Reporting

One live dashboard — every claim, every dollar, every dispute.

Federal Arbitration (IDR)

Underpaid out-of-network claims flow into the No Surprises Act dispute process — prepared by AI, decided by humans.

The Engine

Five AI agents. One human standard.

The AI does the reading, sorting, and computing. Licensed, US-based analysts make every filing decision — by design.

Pre-Claim Intelligence

Coverage, eligibility, and payer status verified before the case happens. Problems surface when they can still be fixed.

Specialty Claim Scrubber

Surgical and assist coding logic — modifiers, unit rules, payer edits — applied to every charge.

Denial Classifier

Every denial triaged and root-caused in minutes. Appeals drafted automatically; patterns fixed upstream.

AR Aging Monitor

Every payer bucket watched continuously. Escalations trigger on thresholds — not on someone remembering.

QPA & Outcome Intelligence

A payer- and procedure-level benchmark database. Every arbitration offer is computed, not guessed.

The Human Layer

US-based analysts review and sign every attestation. Claims that don't qualify are declined — your identity is never on a weak filing.

Out-of-Network & Federal IDR

Intelligence over volume

The best-known arbitration shops win by flooding the system. That model is what payers sue over and regulators write rules against. Ours is built to survive both.

	The Volume Model	The INCISE AI Model
Filing philosophy	File everything; let the arbitrator sort it out	AI screens every claim; only qualified disputes are filed
Eligibility	Fight challenges after filing	Screened pre-filing against current federal remittance rules
Attestations	Bulk filings under your provider identity	A US-based analyst reviews and signs every attestation
Timelines	Promised, then missed	Managed against every federal deadline — tracked, never promised
Built for	The old rules, adapting under scrutiny	The 2026 regime — batching, new fees, Gateway-native from day one

Architecture

Local models do the work.
Frontier AI supervises and teaches them.

An AI node in your building, on your network — reviewed continuously against a quality rubric by supervising frontier models that never see your patients' data.

Your practicePHI stays here → Local AI nodeon your network → de-identified aggregates only → Frontier QAsupervises & teaches

⌂

Your data never leaves the building

On-premise AI processing inside your walls. Protected health information stays local; only de-identified aggregates reach supervising models. BAA executed with every client.

US-based, identity-verified operations

Every person who touches your claims or the federal dispute portal is US-based — aligned with the federal IDR Gateway's access requirements.

↻

A system that learns permanently

Every output reviewed against a quality rubric. Every miss becomes a permanent rule and a regression test.

⇩

Your data, your exit

Complete portability guaranteed by contract — claims, remittances, dispute files, and benchmarks export in usable formats.

Pricing

Simple, aligned, and in writing before you commit

No percentage-of-everything contracts. Pricing follows the work: automation is priced like software; human judgment is priced to the labor; recovery work is contingency-only.

◆

Platform billing — priced like software

Your office runs in-network billing on the platform: AI coding, claims, denials, AR. A fraction of legacy billing rates, for all payers.

◆

Dispute resolution — all-inclusive

Out-of-network negotiation and federal arbitration with every filing fee and arbitration cost included. One rate, nothing hidden.

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Backlog recovery — contingency only

Old denied and unbilled claims from before we arrived. No recovery, no fee — ever.

✓

Implementation — savings guaranteed

A one-time implementation with a year-one savings guarantee: if your first-year INCISE AI billing fees exceed your documented prior billing costs for equivalent volume, we credit the difference.

Your exact pricing arrives with your free revenue analysis — modeled on your actual volume and payer mix, itemized in writing, before you sign anything.

Getting Started

Proof before commitment

You switch when the numbers say so — not when a salesperson does.

Free Revenue Analysis

Send 12 months of remittance data under BAA. An itemized dollar map of your full revenue flow — what the platform can recover, automate, and improve, by payer and by procedure.

2 weeks · no cost, no obligation

Program Design

Per-payer strategy, documentation templates, integration plan. Sometimes the answer is "stay in-network" — and we'll tell you so.

2 weeks

Parallel Run

INCISE AI runs alongside your current biller. Same claims, measured head-to-head: clean-claim rate, denial rate, days-to-cash.

90 days

Cut Over on Proof

Your documented baseline becomes the permanent performance benchmark. One-time implementation, year-one savings guaranteed.

Day 90+

If the numbers aren't compelling, we'll both know in two weeks — at zero cost.

Start with the free revenue analysis. Your data, under BAA, analyzed by the platform and reviewed with you line by line.