Beyond-Claims
Beyond-Claims is the execution layer of the Beyond platform — focused on identifying, correcting, and recovering revenue lost to silent underpayments and misadjudicated claims.
It operates continuously, economically, and deterministically — working the claims traditional RCM workflows cannot.
What Beyond-Claims Does
Beyond-Claims focuses on claims that are typically ignored once payment posts — not because they are correct, but because the cost of manual review outweighs the expected return.
- Audits paid and denied claims continuously
- Identifies recoverable discrepancies at the line-item level
- Builds correction-ready claim data
- Tracks outcomes through verified recovery
Why Traditional Recovery Falls Short
Most RCM operations are optimized for denial management — not for verifying whether paid claims were adjudicated correctly.
Once a claim posts as “paid,” it is typically closed. Partial underpayments, modifier issues, and contract drift persist quietly, compounding over time.
How Beyond-Claims Works
- Evaluates adjudication outcomes deterministically
- Applies repeatable, auditable recovery logic
- Prioritizes claims where recovery is economically viable
- Eliminates dependence on manual follow-up
This allows recovery workflows to scale — including for smaller claims that were previously written off by default.
What Clients See
- Recovered dollars tied to verified payment
- Visibility into payer behavior and enforcement gaps
- Reduction in silent write-offs
- Recovery without added staffing or overhead