The Future of HealthcareClaims Arbitration
ClaimResolve is building the definitive platform for resolving post-payment integrity disputes between payers and providers.
The Market Opportunity
Healthcare claims disputes cost the industry billions annually. The current process is broken.
Annual Healthcare Disputes
Average Resolution Time
Denial Appeal Rate
Admin Cost Per Dispute
Our Solution
A neutral platform that brings payers, providers, and physicians together to resolve disputes efficiently and fairly.
Automated clinical documentation review against InterQual, MCG, and payer medical policies
Board-certified physicians across 40+ specialties providing independent peer reviews
Legally enforceable dispute resolution that eliminates costly litigation
Immutable audit trail with timestamped evidence sharing between all parties
Secure virtual spaces for real-time case presentation and deliberation
Enterprise-grade security with SOC 2 Type II certification
Built for All Stakeholders
A three-sided marketplace serving payers, providers, and physician advisors.
- Faster recovery of legitimate overpayments
- Reduced provider abrasion
- Compliant audit defense
- AI-powered claim analysis
- Defend against unfair denials
- Reduce write-offs and clawbacks
- Neutral physician review process
- Faster cash flow resolution
- Flexible case review scheduling
- Specialty-matched assignments
- Competitive compensation
- Clinical expertise monetization
Why Now?
Rising Audit Activity
Post-COVID recovery efforts have intensified payer audits, creating unprecedented demand for resolution services.
AI Maturity
Large language models can now accurately interpret clinical documentation and medical necessity criteria.
Digital Transformation
Healthcare is finally embracing digital workflows, making a platform solution viable at scale.
Regulatory Tailwinds
CMS and state regulations increasingly favor binding arbitration over litigation for healthcare disputes.
Join Us in Transforming Healthcare Dispute Resolution
We're seeking strategic investment partners who share our vision for a more efficient, fair, and transparent healthcare system.
Reach out for pitch deck, financials, and partnership opportunities.