One engine for Claim Integrity. Before the claim, and after.
Healthcare has no validation at the point where most errors are created. Grelin uses AI to read the claim, apply payer rules, and act. Upstream it fixes the issue before submission. Downstream it audits the claim for accuracy and fraud.
Inside the Workflow
Intelligence beforethe claim is submitted
Traditional revenue cycle management focuses on fixing problems after claims are denied. Grelin focuses on preventing those problems before the claim is ever sent.
What we analyze
Patient eligibility, documentation completeness, coding accuracy, payer policy alignment, and charge integrity — all analyzed before submission.
Real-time risk surfacing
When risks are detected, Grelin surfaces them immediately so teams can correct issues before claims enter the billing workflow.
Upstream resolution
Instead of discovering problems weeks later through denials, issues are resolved while the encounter is still active — at the lowest possible cost.
AI designed specifically for revenue cycle risk
The platform applies automation and machine learning to analyze revenue cycle data in real time, identifying potential claim risks before submission.
Eligibility Validation
Confirms payer coverage, benefit eligibility, authorization requirements, and billing policies before services are billed, helping reduce denials, delays, claim errors, reimbursement risks, and unnecessary rework across the revenue cycle.
Documentation Intelligence
Analyzes clinical documentation to ensure services are accurately supported, properly documented, and compliant with payer-specific requirements, helping reduce denials, coding discrepancies, audit risks, and reimbursement delays.
Coding & Charge Integrity
Identifies inconsistencies between clinical documentation, coding, and billing practices before claims are submitted, helping reduce compliance risks, prevent denials, improve claim accuracy, and minimize costly rework across teams.
Payer Policy Alignment
Continuously monitors evolving payer requirements to ensure claims align with policy expectations before submission, helping reduce denials, improve compliance, minimize reimbursement delays, and strengthen overall claim accuracy.
Revenue Performance Insights
Surfaces operational trends impacting reimbursement across providers, locations, and specialties, enabling healthcare teams to identify performance gaps, reduce revenue leakage, improve decision-making, and strengthen financial outcomes.
Claim Audit and Integrity Review.
Runs a submitted claim through layered audit checks, surfaces accuracy and fraud risk, and returns a ranked, reasoned queue. The same intelligence that prevents the bad claim recognizes one after it is built.
Ranked Reasoned Queue
Live auditCoverage conflict — secondary policy
CLM-8192 · layered audit · reasoned finding
Coding mismatch — modifier bundle
CLM-7703 · layered audit · reasoned finding
Policy alignment — prior auth token
CLM-9021 · layered audit · reasoned finding
Documentation — measurements present
CLM-5521 · layered audit · reasoned finding
29 checks · 6 layers · accuracy & fraud risk
View findings →Built to work with the systems you already use
Grelin is designed to enhance those systems rather than replace them. The platform sits above existing workflows as an intelligence layer, integrating with EHR platforms, billing systems, clearinghouses, and specialty software environments.
This architecture allows healthcare groups to introduce AI-driven revenue integrity without disrupting their current operations.
Integration layer — how Grelin connects
EHR, billing, clearinghouse & specialty — all enhanced, none replaced
Built for healthcare environments
Grelin is designed to support healthcare organizations operating in regulated environments and adheres to industry best practices for data protection and system integrity.
HIPAA-aligned data protection practices
Secure data transmission and storage
Role-based access controls
Audit logging and system transparency
Enterprise-grade cloud infrastructure
The Grelin Platform
Frequently Asked Questions
What is Grelin Health?
Grelin Health is a healthcare AI company that builds the platform for Claim Integrity. The platform validates that claims are correct, complete, and defensible before submission and audits them before payment. It serves payers, providers, pharmacy distribution, and government programs.
What products does Grelin offer?
Four applications on one platform. RxAI validates pharmacy claims across the distribution supply chain. Audit.ai audits claims for payers before payment. RCM.ai validates provider claims before submission. Chart.ai turns clinical documentation into defensible claims, with specialty modules for wound care, pain management, behavioral health, and durable medical equipment.
Who is Grelin for?
Health plans and payers that audit claims. Provider organizations that submit them. Pharmacy distributors that move claims across networks. Technology companies that embed validation into their own platforms. Each group runs a different application on the same underlying platform.
Does Grelin replace billing teams?
No. The platform takes over the manual review work machines do better, like checking a claim against payer policy line by line. Billing teams keep the judgment work: exceptions, appeals, and payer relationships. The goal is fewer claims that need rework, not fewer people.
How does Grelin fit with the systems we already run?
Grelin sits alongside existing systems rather than replacing them. It reads from the electronic health record, practice management, or claims system, runs its checks, and returns results into the existing workflow. Deployment can be direct or embedded inside a partner platform.
How is Grelin different from a claim scrubber?
A scrubber checks format and basic edits at submission. Grelin validates substance: whether documentation supports the codes, whether the payer's specific policy is met, whether eligibility holds. A scrubber catches a missing field. Claim Integrity catches a claim that is clean on format and wrong on content.
Is Grelin a software company or a services company?
Software. The applications are licensed annually and run inside the customer's or partner's workflow. Grelin does not take over billing operations or staff them. The product is validation logic, applied earlier in the claim lifecycle than existing tools reach.
How does Grelin use AI?
Grelin uses AI to read clinical documentation, apply payer-specific policy, and check claims at volume. Every automated verdict carries its reasoning, and exceptions route to human review. AI is the mechanism that makes early validation possible at scale. The product is the validation.