Product
Every record, reviewed together.
You upload the same paperwork your clinic already works with: session notes, treatment plans, claims, and authorizations. Claimo reads them, cross-checks them, and surfaces specific issues with plain-language explanations and suggested fixes.
How it works
From upload to answers in three steps.
01
Upload the paperwork you already have
Session notes, treatment plans, CMS-1500 claims, and authorizations. Batch upload files or whole folders, and Claimo links related records for each client on its own.
02
Claimo reads and cross-checks everything
Each billed line is checked against its supporting note, treatment plan context, authorization, and CPT rules, looking for the patterns that commonly lead to recoupments and payer pushback.
03
Act with evidence
Every finding quotes the language that triggered it, with severity and a suggested fix. Resolve issues and watch the Practice Risk Score trend down.
Document intake
Drop in the paperwork you already have.
Upload session notes, treatment plans, CMS-1500 claims, and authorizations. Claimo reads them, links related records for each client, and starts the review on its own. No new templates, no data entry.
- Batch upload files or whole folders at once
- Notes, plans, claims, and auths linked automatically
- PHI stripped before any external AI review
PDFs and Word documents work as they are, the same files your clinic already produces. Once analyzed, every document lands in a filterable library with its risk level, linked records, and findings, so nothing lives in a folder nobody checks.
Upload
4 documents · 1 client
Session Note - 04.14.pdf
Session note
Treatment Plan - Q2 Review.pdf
Treatment plan
CMS-1500 - Aetna - April.pdf
Claim
Authorization A-3142.pdf
Authorization
PHI stripped before any external AI review
Findings with evidence
Every flag comes with the receipt.
Findings point to the exact language and claim lines that triggered them, with severity, the payer-facing reason, and a plain-language fix. These are risk signals your team can act on, not verdicts.
- Evidence pulled from the source document
- Severity calibrated to what payer reviewers escalate
- Suggested fixes written for clinical and billing teams
Findings land in a review queue where your team confirms or dismisses each one, so you stay the judge. Claimo surfaces risk patterns. It does not accuse anyone of fraud or make legal determinations.
Finding · Claim CF-2087
Critical97155 credential mismatch
Claim line lists an RBT rendering provider; payer policy expects BCBA/BCaBA for protocol modification.
Evidence
“Direct 1:1 session conducted by behavior technician… protocol modifications introduced to manding program.”
Suggested fix
Confirm the rendering credential for this line or rebill under the supervising BCBA per payer policy.
Compliance Risk Index
One score for your whole practice's exposure.
The Practice Risk Score rolls every open finding into a single 0 to 100 index and breaks billed dollars at risk down by driver. Leadership sees where exposure sits and which fixes move the number.
- Billed-at-risk dollars grouped by root cause
- Open flags by severity across the practice
- Score trend as issues get resolved
The score is built from the signals payers actually weigh: documentation quality, authorization gaps, missing records, and cross-document mismatches. Lower is better, and every driver shows the billed dollars behind it.
Practice Risk Score
Lower is better
Documentation quality
$104.8K · 38 lines
Authorization gap
$32.4K · 12 lines
Missing documentation
$27.6K · 9 lines
Multiple issues
$24.7K · 8 lines
Authorization intelligence
Know which auths are burning hot.
Track utilization, expirations, and reauthorization readiness for every client, so an expiring or over-limit authorization never turns into unbillable sessions or a reauth fire drill.
- Units used vs. authorized on every active auth
- Expiration and reauth-readiness watchlist
- Billing patterns that could draw payer scrutiny
Watchlists sort by urgency: which authorizations expire soonest, which are over their unit limits, and which clients need a reauthorization packet started now, before coverage lapses mid-treatment.
Authorization watchlist
Sorted by urgency
A-3142 · Aetna · 97153
9 days left312 / 400 units
A-2987 · United · 97156
Over limit64 / 60 units
A-2411 · Cigna · 97155
On track118 / 240 units
Provider-level breakdowns
See risk the way a payer sees your roster.
Per-provider views show whose documentation is driving risk, where credentials do not match billed codes, and which teams need coaching, well before those patterns show up in an audit letter.
- Risk score and open flags per provider
- Credential vs. CPT checks on every billed line
- Documentation quality trends by team
Common catches include protocol-modification codes like 97155 rendered by staff whose credentials payer policy does not accept, and providers whose notes consistently run thin. These surface as coaching opportunities, not accusations.
Providers
Risk score · lower is better
Provider 07 · BCBA
1 open flag
Provider 12 · RBT
5 open flags
Provider 03 · RBT
3 open flags
Provider 18 · BCaBA
2 open flags
Provider 12 rendered 97155 on 4 lines; payer policy expects BCBA/BCaBA for protocol modification.
Built to assist your team, not replace it.
- No fraud determinations. Claimo surfaces risk signals, not legal conclusions, and never labels anyone a fraudster.
- No automatic claim submission. Your team reviews and submits through your existing billing workflow.
- No replacement for judgment. Claimo supports your legal, billing, clinical, and compliance decisions rather than making them for you.
Start with note QA. Leave with a payer-risk picture.
Join the pre-launch cohort for ABA teams that want notes, treatment plans, claims, and authorizations reviewed together.