Claims, RCM and clinical data, unified.
Trusted data, then AI clinicians believe.
We integrate data across Epic, Oracle Cerner and every downstream payer and lab system, then build models clinicians and operators trust. HIPAA governance, lineage and access control are built in from day one.
AI changes how the work gets done here: the tasks that take a team days run in hours, with your people reviewing the exceptions. It shows up as cost, revenue, and the pace of improvement.
Three companies, three targets. Each moves to the level its P&L needs.
- Claims and denials, Providers: moves from Level 1 to Level 3. Coders work each claim and denial by hand.. Denials predicted before the claim goes out.. Agent codes and files the claim, analyst signs off..
- Staffing reports, Health systems: moves from Level 1 to Level 2. Analysts stitch finance, quality and staffing data by hand.. One dashboard ties finance, patient flow and staffing..
- Member coverage questions, Insurers: moves from Level 1 to Level 4. Staff look up each member's coverage by hand.. Chatbot answers from the member's plan.. Agent drafts a personal plan summary, staff review.. Agents match coverage, claims and care for each member..
Three companies, three targets. Each moves to the level its P&L needs.
- Claims and denials, Providers: moves from Level 1 to Level 3. By hand. Denials predicted. Agent files.
- Staffing reports, Health systems: moves from Level 1 to Level 2. By hand. One dashboard.
- Member coverage questions, Insurers: moves from Level 1 to Level 4. By hand. Chatbot. Agent drafts. Agents match.
Azure
Health data is rich, fragmented and sensitive.
Coding, claims and denials
Coding, claims and denials stay manual and slow, leaving revenue and time on the table.
Records that do not match
EHR, claims and labs rarely speak the same language or live in the same place.
Reporting that stops at the EMR
Real goals need payer, public and niche sources integrated alongside clinical data.
EHR, payer, RCM and diagnostics data reconciled into one governed source of truth, with HIPAA-aware lineage end to end.
Optum
Availity
Coding, claims and denials stay manual and slow, which for the sponsor is revenue already earned and not yet collected. Automating them recovers that revenue and the analysts' time, with accuracy controls and audit built in.
- Healthtech · Level 385%less manual processing time per patient referralElara Caring cut referral-to-admission time from days to under 24 hours
- Healthtech · Level 295%less time from document arrival to searchable recordRedica Systems cut FDA document processing from 2 days to under an hour
- Healthtech · Level 285%accuracy predicting churn 90 days aheadMasterControl flags customer churn 90 days early with 85% accuracy
Three stages and an advisory retainer, with published prices.
- Find where AI paysStage 1 of 3
Assess
Know where AI creates value.
- Time
- 2 to 4 weeks
- Price
- $25K to $50K
A free diagnostic first, then the full readout: opportunity map, ROI model, 90-day plan, board-ready.
Explore Assess - Build the first workflowStage 2 of 3
Build
Ship the first workflow.
- Time
- 3 to 6 months
- Price
- $75K to $350K
A senior pod takes one function to Level 3 (software runs the workflow, people review the exceptions) in production. First workflow live by day 100.
Explore Build - Repeat it across the portfolioStage 3 of 3
Scale
Repeat it across the book.
- Time
- Per year, annual agreement
- Price
- $250K to $1.5M+
What ships at company one is the starting point at company two. 3 to 15 companies.
Explore Scale - A senior AI lead on retainerAlongside every stage
Advisory
Fractional AI leadership.
- Time
- Monthly, 3-month minimum
- Price
- $15K to $30K / mo
A Portfolio Success Partner for board reporting, governance, and vendor management.
Explore Advisory
Common questions.
What does Blue Orange do for healthtech companies?
We integrate data across Epic, Oracle Cerner and every downstream payer and lab system, then build models clinicians and operators trust. HIPAA governance, lineage and access control are built in from day one. Trusted data first, then AI clinicians believe.
Which healthcare systems does Blue Orange read from?
Epic, Oracle Cerner, MEDITECH and Veradigm for EHR and clinical data, Optum and Availity for payer, claims and RCM, and Labcorp for diagnostics. EHR, payer, RCM and diagnostics data are reconciled into one governed source of truth, with HIPAA-aware lineage end to end. We build on Claude and Databricks.
Can AI help with coding, claims and denials?
Yes. Coding, claims and denials stay manual and slow, leaving revenue and time on the table. Automation for coding, claims and denials recovers revenue and analyst time, with accuracy controls and audit built in; the target is Level 3 (L3), where an agent codes and files the claim and an analyst signs off.
How does Blue Orange handle HIPAA and patient data?
HIPAA governance, lineage and access control are built in from day one. Reconciled EHR, payer, RCM and diagnostics data carry HIPAA-aware lineage end to end, and automation for coding, claims and denials ships with accuracy controls and audit built in.
What does the PE sponsor get from healthtech data and AI?
Revenue the company has already earned and not yet collected. Automation for coding, claims and denials recovers revenue and analyst time, and executive dashboards connect financial, quality, patient-flow and workforce data so leaders allocate resources with confidence.
How do we start, and what does it cost?
Book a free diagnostic. For a healthtech company it usually starts with claims and denials: a read-only look at your EHR, payer and RCM data places you on our five AI maturity levels (L1 to L5), with a six-dimension readout and a ranked workflow list. It is complimentary for qualified companies; the full Assess is 2 to 4 weeks at $25K to $50K fixed.