Healthcare AI Solutions for Claim Integrity | RxAI, Audit.ai, RCM.ai
Grelin builds healthcare AI solutions for Claim Integrity: pharmacy claim validation, pre-payment claim auditing, and AI revenue cycle management. Each application runs on one intelligence platform and is purpose-built for a specific business on the claim.
Platform feeds applications
One platform. Four markets. Every claim workflow.
Every Grelin application runs on the same intelligence platform. Playbooks encode payer logic, billing rules, and specialty requirements before a claim ever moves.
What one application learns, every application inherits. That is what makes Claim Integrity possible across the whole claim lifecycle.
Grelin's Flagship Solutions
Our three central customer-facing engines power claim integrity operations across different organizational workflows. They are built with maximum visual prominence and act as the primary operational workspace.
For Pharma Distributors
RxAI
Claim Integrity for pharmacy claims at distribution scale.
RxAI is an AI-powered pharmacy claim validation platform that checks payer rules, formulary requirements, prior authorization, and clinical documentation before prescription claims are submitted.
Pharmacy claims move fast and fail quietly. A single coding error or payer rule miss repeats across thousands of transactions before anyone sees it.
RxAI validates pharmacy claims against payer logic before they move. Errors get caught at the source, not discovered in reconciliation.
Distributors and their pharmacy networks get cleaner claims, fewer reversals, and revenue that arrives the first time.
- Validates claims against payer-specific logic before submission
- Catches repeat errors at the source instead of in reconciliation
- Scales across entire pharmacy networks from one platform
For Payers
Audit.ai
Claim Integrity for pharmacy claims at distribution scale.
Audit.ai is an AI payment integrity platform that audits healthcare claims before payment to identify coding errors, coverage conflicts, documentation gaps, and fraud risk.
Payers audit claims after they pay them. Recovery is slow, adversarial, and incomplete.
Audit.ai moves the audit upstream. Claims get screened against coverage rules, coding standards, and historical patterns before payment is released.
Overpayments stop being a recovery project. They stop happening.
- Screens claims against coverage and coding rules pre-payment
- Flags patterns human auditors miss at volume
- Turns post-payment recovery into pre-payment prevention
For RCM and Billing Companies
RCM.ai
Claim Integrity across every client, specialty, and payer you bill for.
RCM.ai is an AI revenue cycle management platform for billing companies that validates claims across every client, specialty, and payer before submission.
Billing companies absorb the rework their clients create. Every denial worked is margin lost on a contract priced for clean claims.
RCM.ai applies Claim Integrity across your entire book of business. Playbooks run client by client, specialty by specialty, payer by payer, so errors get caught before submission instead of worked after denial.
Claims go out certified. Rework drops. Margins recover. Clients see the difference in their first remittance cycle.
- Runs Playbooks across every client, specialty, and payer from one platform
- Catches errors before submission instead of working denials after
- Turns clean claims performance into a client retention story
Specialized Applications
These applications extend the flagship products with deep, target-specific intelligence. They are built directly into the platform rather than acting as equal standalone pillars.
Ready to move upstream
If your business runs on
claims, it runs through Grelin.
Wherever you sit on the claim, there is a Grelin application built for how your work actually happens. Let us secure your claim integrity.