Every claim. Every payer. Every dollar explained.
ClaimYours AI finds what you were underpaid, fixes what’s about to be denied, and tracks every case to the payment. You approve. We do the work. For any independent practice. Built for Ohio DODD waiver billing.
Four steps. You own the last one.
Works from the files your clearinghouse and EHR already produce (837, 835, 999, 277CA); direct connections are set up and tested with each practice and vendor. Ohio DODD providers get Ohio’s own rules on top.
Connect
Upload or connect your claims, remittances and payer contracts. Works from the files your clearinghouse and EHR already produce (837, 835, 999, 277CA); direct connections are set up and tested with each practice and vendor.
Compare
Every line checked: expected vs paid, against your contract or your payer’s real history.
Propose
We draft the fix, the appeal, or the records packet, with the reason and the source.
Approve
One inbox. One click. Tracked until the money lands.
No guessed dollars
Every variance traces to a claim line and a contract line, or it’s labelled unexplained.
Nothing goes out without you
Every fix, appeal and packet waits for a human approval, logged with who and when.
Your data stays in AWS
PHI never leaves our HIPAA environment. We never become your submitter.
The claims that pay wrong don’t show up on any report you already run.
They post. They reconcile. They balance. And they leave your money on the table every single cycle.
Your tools were built to submit claims. Not to catch the ones that pay wrong.
A clearinghouse checks that a claim is valid: formatted right, codes present, not obviously rejectable. It passes. It pays. Everyone moves on.
But valid isn’t correct. A claim can pass every format check and still pay below the rate you are owed, bill the wrong county rate, or exceed an authorization. Those don’t always bounce. They underpay you, or they deny weeks later.
ClaimYours AI looks, against the published rules, before the claim ever leaves.
One engine, with honest status
Ohio DODD is available today, and so is the universal engine for any practice and billing company. The others are at different stages, and each page says exactly where.
DODD
Ohio DODD waiver claims checked against the full rule registry, with fixes you approve and files you submit.
See how it works →Behavioral Health
Ohio behavioral health checks before submission, priced with the published ODM fee schedule you confirm.
See how it works →VA
Community Care claims matched to their HSRM referrals before submission: the number, the dates and the visits left.
See how it works →Home Health
PASSPORT, MyCare and Home Care Waiver lines checked against EVV visits and the service plan before submission.
See how it works →Any independent practice
Dental, chiro, PT/OT, primary care, specialty. Bring your contracts; we find the gap between what you were paid and what you were owed.
See how it works →Billing companies
Every client’s claims under one login, each in its own workspace, with a record of who approved what.
See how it works →You stay in control at every step.
Every claim is checked
The moment a claim arrives, it is checked against the rules for its rail. Each result shows the rule and its source.
Fixes are proposed
When the platform knows the fix, it proposes it. When a fact is missing, it asks the right person and re-checks when the answer comes back.
You approve and submit
You approve the changes you want. The platform stages the file. You submit it through your own route. Nothing leaves without a person pressing the button.
The teammate that reads every claim before you submit it.
ClaimYours AI checks each claim against Ohio’s published rules the moment it arrives and shows the rule behind every result. When it knows the fix, it proposes it. When a fact is missing, it asks the right person and re-checks when the answer comes back.
It never submits a claim. A person on your team approves every change and presses the button.
Built for Ohio agencies with staff and real volume.
Multi-county and multi-program agencies
Where rate and authorization complexity hides the most money, and where a spreadsheet stops keeping up.
Agencies without a billing analyst
An office manager can’t check every line against every rule. The platform does the checking. Your team approves.
Providers working with a billing company
Even with an outside biller, preventable denials start upstream. Check them before they reach the queue.
Questions Ohio agencies ask.
Do you submit claims for us?
No, and that is deliberate. ClaimYours AI stages the corrections. You review them, approve them, and submit through your own route. For DODD, that means you upload the file to eMBS.
Do we send you files?
Not through this site. This site never accepts files or patient information. Uploads happen inside ClaimYours AI, after your account is approved and the Business Associate Agreement is accepted.
Which rails are live?
DODD, behavioral health, VA Community Care and home health are available. Each rail page lists what works today and what is still to come.
How do you know the rates are right?
Rates are checked against the published rate appendices. Where a rate has not been verified yet, ClaimYours AI says so and does not show a number.
Is our data safe?
ClaimYours AI is hosted on AWS in the United States. We sign a Business Associate Agreement before any patient data is shared. This site never collects patient information. Read more on security.
What does the free audit cost?
Nothing. Tell us about your practice and a real person will show you how ClaimYours AI would check your claims. No pitch, no obligation.
Three problems every billing office knows
Claims sit denied for weeks
A denial shows up days after you submit, then waits in a queue until someone has time to work out why.
Nobody knows which rule failed
A denial code tells you something is wrong. It rarely tells you which rule, or what to change.
Adjustments never get filed
Short pays and underbilling are easy to miss, and easy to put off until the window closes.
Made around the systems Ohio providers actually use
Each rail runs on its own rules, files and agencies, not a generic national rulebook.
Ohio DODD
Waiver claims checked against the service rules in OAC Chapter 5123-9, with corrected files staged for eMBS.
County boards & PAWS
All 88 Ohio counties mapped to their rate categories, and units checked against the PAWS authorization on file.
ODM behavioral health
The ODM Behavioral Health Provider Manual and the Ohio Medicaid BH fee schedule (OAC 5160-27-03), checked before an MCO sees the claim.
Home care programs
PASSPORT, MyCare Ohio and the Ohio Home Care Waiver, matched to your Sandata or HHAeXchange visit records.
VA Community Care
Every claim matched to its HSRM referral and paid against your Community Care Network agreement.
Your payer contracts
For any other practice, each paid line is compared with your contract rate or what that payer has really paid you.
Patient data stays inside the platform
From sign-up to your first checked claim
Sign up
Create an account, or start with the demo to see the platform first.
Approved
A person at ClaimYours AI reviews and approves your account.
BAA accepted
Your practice accepts the Business Associate Agreement inside the platform.
Upload & check
Upload claims inside your account and see every result with its source.
See how every claim gets checked.
Try the demo yourself, or ask for a walkthrough. No patient information needed.