We turn messy records and bills into auditable, URAC-grade decisions at machine speed—so IDR entities and IROs can handle millions of determinations without hiring sprees.
Channel-agnostic intake routes fax, portal, and API submissions.
The regulation forces IDR entities and IROs to demonstrate line-item specificity and publish how fast they respond. These three pressure fronts are why teams are rebuilding intake and determination flows around claymor.
72 hours (urgent) / 7 days (standard); specific denial reason required across all channels by Jan 1, 2026; public PA metrics due Mar 31, 2026; FHIR PA APIs by Jan 1, 2027.
IDR and external review demand is compounding. Plans and delegates need industrialized line-item reasons and reporting to stay compliant.
Manual minutes per prior auth remain high. Coding-driven denials often surface post-service—non-compliant with the new specific-reason mandate unless shifted upstream.
Generic summarizers won’t pass audit. Claymor uses a modular, contracted agent graph that operates on line-item primitives—every step is explainable, cited, and connected to the Evidence Store and CMS clocks.
Explore the Agent SpecsInspect the same controls customers rely on for IDR, IRO, and utilization management audits. Hover or tap through the playbook to see what each agent-ready workspace delivers.
Capture each asset directly from your internal sandbox so prospects can see the transformation—then ship lightweight formats with the alt text below for accessibility.
Pages of a fax morph into normalized line items, policy checks light up, denial reasons appear, and the clock stops inside the metrics tile.
1440×900, ≤1.8 MB, WebM/MP4/GIF
From fax to line-item prior-auth decision with specific denial reasons and timer captured.
Three cards summarizing regulatory deadlines, volume pressure, and labor constraints—no logos, just editorial numerals.
PNG, export @2×, ≤90 KB
Claymor regulatory stat cards for CMS-0057-F milestones.
Horizontal nodes pulsing across Intake → Normalize → Chronology → Line Extract → Coding → Pricing → Rules → Rationale → QA → Export.
Lottie, 6–8s loop, ≤600 KB
Agent pipeline from intake to export with neon pulse.
Side-by-side denial reason upgrade plus toggle to view PAS ClaimResponse JSON for the selected line.
Interactive PNG/GIF set
Claymor reason explorer with PAS narrative toggle.
Synthetic dashboard highlighting all PAs, median time to decision, 100% specific reasons, and delegate reporting with a sparkline.
PNG, ≤120 KB
Claymor metrics ledger dashboard with compliance badges.
Governance is embedded in every agent. Immutable ledgers, provenance, and effective-dated rules keep URAC auditors, compliance teams, and delegates aligned to CMS-0057-F mandates.
Capture clock starts/stops and publish-ready dashboards without manual spreadsheets.
Every extracted field cites the page coordinate or EDI segment it came from.
Rules versioning, per-tenant isolation, and BYOK encryption options keep compliance teams in control.
Demo Asset E — Metrics Ledger Dashboard
Include a sparkline for clock stops/resumes and ship the asset with the synthetic data above.
See how claymor helps your organization master the demands of IDR, IRO, and CMS-0057-F today.
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