Every line on the Conditional Payment Letter, matched to the record — or disputed.
Conditional payment review services read every line of a Conditional Payment Letter against the treatment record: a five-hundred-line CPL against as many as 1,200 pages. Each charge is classified injury-related or unrelated, with the page behind the call, assembled as the line-by-line dispute the recovery contractor answers in writing.
The rulebook is statutory. So is the referee.
We do not build for a case type until we can name the standard that defines a correct output and the person who grades the file against it. In Medicare Secondary Payer work both are written down, and the grading happens one line at a time.
That is the rare case where an AI read can be checked against something objective: the recovery contractor's written response tells you, charge by charge, whether the read was right.
Hundreds of charge lines against hundreds of pages.
A lien file runs 200 to 1,200 pages, around 700 in the middle of the range, and it almost never arrives as one clean production. Provider records come in waves, the payer's charge listing arrives separately, and the two have to be reconciled against each other before a single line can be called related or unrelated.
What makes it slow is not the volume so much as the condition: fax-degraded scans, handwritten progress notes, the same discharge summary appearing in three productions, and occasionally a page that belongs to another patient entirely.
An estimated 300,000 to 450,000 lien files a year move through resolution vendors and firm lien departments.
Roughly 35% to 45% of mass tort claimants are Medicare or Medicaid beneficiaries, so the same read repeats across the inventory.
Four steps, starting with one real file.
Send one real file
A Conditional Payment Letter and the treatment records behind it, in whatever shape they arrived in. In the demo case that is 342 pages across 2 packets, with a wrong-patient page quarantined before the read starts.
We return the read
Every charge line classified injury-related or unrelated, with the date of service, the provider, and the page that supports the call. You check it against what your own analyst would have written.
We scope the build
Charge volumes, how many productions a typical claimant generates, your dispute template, and the export your team already files. If the case type is not buildable at your volumes, we say so at this step.
You run it
Your lien department runs the file at its own volume. Your analysts decide which lines to dispute and sign what goes to the recovery contractor. The platform never files, submits, or negotiates anything.
The rules the platform never breaks.
EVERY LINE CITED
HIPAA, under a signed BAA
Every file is handled under our Business Associate Agreement, from the first byte.
Never trains a model
Your records are never used to train any AI model — ours or anyone else's.
Every line cited
If we can't cite it, we don't say it. Every sentence links to its source page.
Deleted after delivery
Files are deleted 30 days after delivery, with a full audit log of every access.
Four capabilities behind every charge line.
The conditional payment read is one deliverable of the same platform that reads, sorts, and cites the whole record.
Claims Billing Ledger
Dates of service, providers, and billed lines pulled into one ledger you can sort against the Conditional Payment Letter.
Treatment Relatedness
Each treatment tied back to the accepted injury or flagged as unrelated, with the page that shows which of the two it is.
Medical Chronology
The treatment timeline builds itself from every production, so a charge date always has the visit behind it.
Verifiable AI Citations
If we can't cite it, we don't say it. Every classified line links to the page range it came from.
Conditional payment review, answered.
Send one file. We'll tell you what we can read.
No obligation. If the case type is buildable we'll scope it; if it isn't, we'll say so.