Bring one clear standard to your hardest claims.
Orchid connects a claim to the payer rules that apply, shows what the evidence supports, and says plainly what still needs a person's judgment.
Orchid does not replace your billers, your billing platform, or professional judgment.
We work with a limited number of RCM organizations handling professional specialty claims within Orchid's current scope, and with specialty practices directly.
Where Orchid can help
Less hunting. More consistent reimbursement decisions.
These are the areas a first review measures with you.
Less digging before a decision
Reviewers open a case with the payer rules and evidence already pulled together.
More consistent answers across reviewers
One shared basis, so similar cases are less likely to land in different places.
Answers you can explain to clients
Every material finding keeps its evidence, so you can say why.
Why that can work: the applicable payer evidence stays with the finding, we say where the evidence is thin, and your team keeps the final decision.
The hard claims cost the most to answer.
A practice asks whether it got paid right. You also have to ask what that answer costs in skilled hours, across every provider you serve.
Your best people become the bottleneck
Hard payer questions pile up with the few people who know the most.
Finding the rule takes longer than the decision
You may have to chase policies, dates, claim details, and past decisions before you can decide anything.
Two reviewers, two answers
When evidence and reasoning live in different places, similar cases get handled differently.
Works with what you already run.
Step 1
Claims and payer context
Step 2
Orchid evidence layer
Step 3
Reviewer decision
You keep the client, the billing workflow, and the final call. Nothing about your billing platform or how you submit claims has to change to start.
More people is not more judgment. Extra reviewers add capacity, but they do not automatically agree on which payer rule applied or what the evidence supports. Orchid gives onshore, offshore, and hybrid teams one shared standard.
Look back first. Then get ahead of it.
Review
Learn from what already happened.
Monitor
See when the pattern repeats.
Prevent
Apply what was learned before submission.
Recover
Act where the evidence supports it.
Start with Review today. Monitor, Prevent, and Recover describe where Orchid is headed.
Start where we are strongest.
We know outpatient podiatry claims best. If you serve many specialties, that makes a good first set to test Orchid on before going wider.
Current scope: professional specialty claims, with the most depth today in outpatient podiatry. Hospital and institutional claims and production-PHI workflows are not part of the current offer.
Start small
- Pick a bounded claim population and question.
- Compare Orchid’s findings with your reviewers.
- Decide whether the evidence justifies going further.
Bring us one reimbursement workflow.
15 to 30 minutes. Discuss a reimbursement workflow or recurring claim issue and whether a focused Orchid Review may be a fit.