The claim you submitted isn't always the claim that got paid.
ClaimTrace reconstructs post-adjudication claim history for medical billing companies — surfacing suspected modifications, reimbursement discrepancies, and contract underpayments for analyst review. Runs on Microsoft Windows, on your own hardware.
Free trial installer for Windows · No clearinghouse · Never submits claims
Your billing system submits. ClaimTrace watches everything that happens next.
Import the EDI your workflow already produces — no integration project, no changes to how claims go out. ClaimTrace rebuilds each claim's chain and compares every adjudicated line against what you submitted and what your contract says.
- 837Submission
Claims imported and preserved exactly as submitted.
- 999 · 277CAAcknowledgment
Clearinghouse and payer receipts correlated to each claim.
- 835Adjudication
Remittances matched to claims, line by line.
- ΔComparison
Submitted vs. adjudicated vs. contracted — every discrepancy scored.
- FindingAnalyst review
Evidence-backed findings confirmed by your team, never auto-labeled.
- $Recovery
Appeal packages assembled; every recovered dollar validated.
Six instruments, one chain of evidence.
One claim, its whole story
Journey, financials, submitted-vs-adjudicated comparisons, and an evidence index — every number one click from the source file that proves it.
Modification detection
Versioned detection rules flag suspected downcoding, modifier removal, unit reductions, and bundling — each candidate scored, with alternative explanations preserved.
Expected vs. actual
Load your fee schedules and every remittance is checked against the rate the payer agreed to — turning "paid less" into "paid less than the contract."
Behavior, not incidents
Recurring payer behaviors surface across claims and clients, with full statistical documentation — method, thresholds, and limitations stated.
Evidence packages
Versioned, tamper-evident ZIPs — documents plus original EDI exhibits with a SHA-256 manifest — tailored for payer, regulator, or attorney audiences.
Validated dollars
Recoveries are tracked from appeal to deposit and only count once an analyst validates the money actually landed. Reversals are tracked too.
Every conclusion stands on a file you can hand to an attorney.
sha256 1a5f70123f7881ebfb244adbdd598c6c08e318c8c0589ddb52b9071a07aaa4a6 · synthetic-claims-026-837.edi
Immutable source
Original EDI is content-addressed and never modified. Corrections become new revisions; the original remains, hash intact.
Cautious by design
The engine reports suspected modifications and preserves alternative explanations. Analysts confirm findings; nothing is ever auto-labeled as misconduct.
Windows, on your network
ClaimTrace installs on a Windows PC or office server from a single signed installer. Claim data never leaves your network.
Beside your stack, not in it
Not an EHR, PM system, or clearinghouse — ClaimTrace never touches claim submission. It audits outcomes independently, from the same files you already have.
From one changed code to a payer-wide pattern.
Evaluate ClaimTrace on your own machine.
Every install includes a synthetic sample dataset — about 850 claims across six payers — so you can walk the full revenue-assurance and forensics workflow before importing a single real file. Tell us who you are, then download the Windows installer.
- Signed Windows installer · runs on your hardware
- Sample data included for guided evaluation
- Pricing and licensing on request — no prices on this page
Prefer a walkthrough first? Email hello@exactedi.com
Request your trial download
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Thanks — your Windows trial link is good for about 4 hours and is meant for one download session. The installer includes the synthetic evaluation dataset.