IDENTIFY. CAPTURE.
SAVE MONEY.
An AI Platform That Reconciles Erroneous Ambulance Claims.
We review emergency ambulance claims against clinical records before payment occurs, preventing improper higher-level-of-care billing without disrupting your existing workflows.
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An annual multibillion-dollar inefficiency in ambulance billing.
Ambulance claims are paid at the level submitted, because the records that would contradict them are almost never reviewed — a persistent financial leak across Medicare Advantage and commercial plans.
The Inefficiency
Insurers lack the specialized infrastructure to efficiently audit every ambulance claim, leading to routine overpayments for top-level care when a lower, less costly level was actually required.
The Failure of Current Solutions
Standard randomized retrospective audits are slow, resource-heavy, and fail to recover meaningful capital.
Improper Medicare ambulance payments, about $595M a year, mostly unsupported by records.
Top-level ALS claims charged higher than the patient's own records support.
Improper payments across all payers annually, most of it never measured.
No Systems Overhaul. Measurable Savings.
Our AI-driven proprietary platform works alongside your existing claims process to deliver compounding financial returns.
Read the Records
We securely ingest clinical records and claims via multiple sources.
Compare to Payer Rules
Every claim is checked against clinical documentation and payer medical-necessity rules.
Flag Overbilled Claims
Claims that don't meet medical necessity criteria are automatically flagged for review.
Deliver Savings to the Plan
A detailed report goes to your team, ready for auditing and recovery.
Smarter With Every Claim
Each review sharpens the model, improving detection accuracy over time.
Built for one job. Defensible by design.
A purpose-built engine, protected by data access and domain expertise no generalist tool can replicate.
Purpose-Built Payment Integrity
Built specifically to uncover complex billing and coding issues that general payment-integrity tools can miss.
Proprietary Data & Analysis
Securely ingest all of the data and information associated with the ambulance transport and medical record to ensure payment integrity.
Deep Domain Expertise
Combined decades of healthcare, billing, compliance, fraud investigation, and payment-integrity experience with technology designed around real-world claims review.
Led by Industry Veterans
Establishing enterprise trust through decades of hands-on experience across medtech, billing, and healthcare compliance.
Over 25 years of leadership across medtech and life sciences; former CEO of AVACEN Medical and CMO of ReadySet Surgical.
More than 30 years of specialized expertise in medical billing, healthcare compliance frameworks, and audit defense structures.
Over 30 years of experience in the healthcare industry, with extensive experience in global product launches, strategic market development, sales and marketing, and a strong focus on startup companies and emerging technologies.
Over 25 years of experience in healthcare fraud investigations, regulatory compliance, and corporate governance.
Capitalization & Market Scale
An early seat in a $2B compliance opportunity — IntegraRev is raising a seed round to bring the first EMS-specific claims integrity engine to market.
Targeted Expansion
Launching via Medicare Advantage plans — the largest and least-monitored sector — followed by commercial carriers and structured ambulance company compliance accounts.
Capital Allocation
Funds are directed toward scaling beta test sites, publishing validated white papers, securing key regulatory/medical experts, and expanding the commercial customer-facing team.