One platform, built for the full claim lifecycle.
Most payment integrity firms own one piece of the lifecycle. ClaimReturn operates the whole arc — pre-pay through post-pay through clinical validation — as a single system where every recovery feeds the next cycle.
How it works
A continuous loop, not a line.
Pre-pay screening, adjudication, post-pay recovery, and clinical validation operate as a single feedback loop. Each cycle teaches the next.
Go-To-Market
From kickoff to full intelligence.
A three-phase implementation roadmap designed to deliver value at every milestone — not just at the end.
Phase 01 · Days 1–30
Foundation
- Data ingestion and claims feed integration
- Baseline leakage assessment completed
- Fee schedule and contract loading
- Clinical rule library configured to your population
- Executive dashboard live and accessible
Phase 02 · Days 31–90
First Savings
- Pre-pay review fully operational
- First post-pay recovery queue delivered
- Coding validation reports issued
- Provider communication protocols active
- 90-day savings analysis presented to leadership
Phase 03 · Days 91+
Full Intelligence
- AI anomaly models tuned to your claim patterns
- Continuous improvement loop operational
- White-label deployment (if applicable)
- Quarterly executive benchmark reporting
- Expansion to additional plan populations