Which treatment belongs to this injury? Tagged line by line — you adjudicate.
Treatment relatedness and compensability software tags every visit and charge related, unrelated, or disputed relative to the covered incident, with the reasoning and citations behind each tag. Tags are provisional signals, not compensability determinations — any tag can be overridden, and a mandatory adjudicator sign-off is required before anything is final.
Every tag arrives with its reasoning attached.
Each visit and charge is read against the covered incident — mechanism, body part, date — and tagged related, unrelated, or disputed. Open any tag and the reasoning is there: the passages it rests on, cited to the page, one click from the source.
Pre-existing conditions, separated — not smoothed over.
Prior treatment to the same body part is pulled from the record itself and set beside the post-incident care. Lines tied to a pre-existing condition tag unrelated or disputed with the prior-history citation attached — the evidence your apportionment review needs, without the AI making the apportionment call.
The sign-off gate: AI tags, the adjudicator decides.
Override any tag, one line at a time — the original suggestion and your override are both kept, logged with user and timestamp. Until the adjudicator signs off, the file stays provisional: no payment posts, no denial issues, no reserve moves. The gate cannot be disabled.
Signals with citations — never a compensability determination.
Every tag traces to the pages it rests on, and every conflict is flagged rather than resolved by the machine. That is what makes the output audit-grade and legally defensible: when the determination is questioned later, the file shows the evidence, the AI's signal, and the human decision — separately.
See Verifiable AI CitationsFrom claim file to signed relatedness review.
Three steps — the AI does the reading, your adjudicator does the deciding.
Records, bills, and the incident description — any format, any volume, no manual sorting.
Related, unrelated, or disputed per visit and charge — reasoning and page citations attached to each.
The adjudicator accepts or overrides each tag, then signs — only then does anything move downstream.
Who works the relatedness question.
Same tags, different desks: the adjudicator's queue, the TPA's client file, the defense attorney's causation argument.
Adjusters open the file with every line pre-read and cited — and keep full authority over the determination.
For carriersRelatedness worked consistently across adjusters and clients, with the reasoning trail ready for any client audit.
For TPAsThe causation argument, mapped to the record line by line — with the pre-existing history already on the table.
For law firmsRelatedness signals, answered.
Prior treatment is surfaced from the record itself — earlier packets, earlier providers — and lines tied to a pre-existing condition are tagged unrelated or disputed with the prior-history citation attached. That gives your apportionment review its evidence; the apportionment call itself stays with your team.
Yes — any tag, one line at a time, without disturbing the rest. Every override is logged with user and timestamp, and the original AI tag and reasoning stay in the file so the record shows both what was suggested and what was decided.
No. Tags are provisional signals with citations, not a compensability determination. Nothing downstream — payment, denial, reserve — moves until the adjudicator reviews and signs off, and the sign-off gate cannot be disabled.
Each visit and charge is read against the covered incident — mechanism, body part, and date — and assigned one of three tags. Clean matches tag related, clearly separate care tags unrelated, and anything with conflicting evidence, such as a pre-existing complaint in the same body part, tags disputed for human attention.
The cited record passages the tag rests on, the linkage (or gap) to the covered incident, and any prior-history references — each citation clickable to its source page. The trail is preserved in the file, so a later reviewer or auditor sees exactly why each line carries its tag.
Related capabilities
How the condition actually moved over time — the context behind each tag.
ExploreRestrictions and work-status changes pulled from the same record.
ExploreThe same flag-don't-decide pattern, applied to the whole case file.
ExploreOnce relatedness is decided, check whether the charge itself is reasonable.
ExploreSee your next claim file tagged line by line.
Upload a file and get the relatedness tags back, cited — with the sign-off gate exactly where it belongs. Handled under our BAA; never used to train a model.