Resolve healthcare claim disputes in days, not months
ClaimResolve is the neutral, AI-powered platform where payers, providers, and independent physicians settle medical necessity disputes with binding arbitration — all in one secure workspace.
Trusted by payers, hospitals, and a nationwide network of board-certified reviewers.
One neutral platform for every party
Everything payers, providers, and physicians need to resolve disputes efficiently and fairly — from AI analysis to binding decisions.
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
See the Platform in Action
Powerful dashboards and AI-driven insights for every stakeholder.
Win More Appeals with Smarter Strategies
Track recovered revenue, monitor success rates, and manage pending appeals all from one dashboard. AI-powered insights show you exactly which denials to prioritize.
- Denial breakdown by reason with win rate analysis
- Real-time recovery and success rate tracking
- Quick actions for immediate appeal submission
Resolve Claims Faster with Global Settlements
Group similar claims for efficient resolution. Track proposals, negotiations, and settlements in real-time across every active batch.
- Intelligent claim grouping by DRG and denial reason
- Real-time negotiation status tracking
- Settlement proposal management
Deep Clinical Analysis in Seconds
Our three-step AI engine extracts evidence from clinical notes, maps against payer policies, and detects conflicts automatically — with actionable recommendations.
- NLP-powered evidence extraction from clinical notes
- Automated policy mapping and conflict detection
- Historical analysis with match scoring
Built for every party in the dispute
A neutral workspace that serves payers, providers, and independent reviewers alike.
- 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, remote case review scheduling
- Specialty-matched assignments
- Competitive per-case compensation
- Full clinical documentation access
Get paid for your clinical expertise — on your schedule
Join an independent network reviewing medical-necessity cases remotely. Flexible, asynchronous, and specialty-matched.
Per-case compensation
Time per case
Payout cadence
Fully remote
How it works
- 1
Apply & verify
Tell us your specialty and NPI. We verify licensure against national registries — usually within 1–2 business days.
- 2
Get matched
Accept specialty-matched cases from your queue. Each comes with the full clinical context already assembled.
- 3
Review & get paid
Submit your independent medical-necessity opinion. Track completed reviews and earnings, paid biweekly.
Join the ClaimResolve Review Network
One consortium for case management, utilization review, and physician advisors. Verify your NPI, choose your discipline, and create your account in under a minute — we'll autofill your details from the national registry.
- Instant NPI verification
- No lengthy application form
- Start reviewing once approved
Independent by design
Your clinical judgment is your own. Opinions are never directed or predetermined by ClaimResolve.
HIPAA-compliant & BAA-backed
Every reviewer signs a Business Associate Agreement. PHI is encrypted in transit and at rest.
Credentialed peers
Board-certified physicians (MD/DO) and licensed clinicians — RNs, NPs, PAs, coders & CDI specialists.
Full documentation access
Immutable audit trail and timestamped evidence for every case you touch.
Start resolving claims with ClaimResolve
Choose a plan that fits your organization, or talk to us about enterprise onboarding for payers and health systems.