Stop guessing what your payers want. Get a guarantee instead.
Concordance checks every clinical note against your payer's real, live rules — before the claim is ever submitted — then seals it against clawbacks. The reactive, post-audit scramble ends here.
Read-only EHR connect · No sales call required · See your clawback exposure in 48 hours
The clawback is the worst part — and you never see it coming.
Your clinicians write a note, guess at what the insurer wants, and submit. Months later the payer pays… then asks for the money back. By the time you see the pattern, it's already an audit.
The worst part for me is when the payer pays and then they ask for a refund — being that they have reviewed and realized there's a documentation issue.
I spent literally four days at my desk going through notes line by line, comparing them against everything the payer was saying — just to meet their criteria.
The only compliance layer wired into both sides.
Everyone else audits documentation from the provider's side and guesses the insurer's rules from public manuals. Concordance is connected to the payer too — so a green light isn't a guess. It's an agreement.
Provider Cockpit
Real-time and batch checking of notes against the exact payer's live rules. One-click AutoFix drafts the missing language in your EHR. Clawback exposure, quantified by provider, payer and code.
Payer Console
Insurers publish their real rules and clawback triggers once, and get a pre-payment view of documentation quality. Fewer disputes, lower audit spend, less provider abrasion.
The Concordance Ledger
The proprietary record of what each payer actually accepted, denied, or clawed back — built from real adjudication outcomes, not public PDFs. The moat no one-sided tool can ever start.
Not a refund if you're clawed back. A promise you won't be.
Other tools insure against a bad outcome — they pay you back after the clawback. Because the payer is a partner on the Concordance network, a green light is a pre-adjudication agreement: the payer agrees up front not to claw back charts that passed. We don't reimburse the loss. We prevent it at the source.
Sealed
It will not be clawed back.
Tuesday morning, inside Concordance.
Follow Maria, who runs billing at a 30-clinician behavioral-health group, as one note moves from risky to sealed — without leaving her EHR.
A clinician signs a note — Concordance was already reading along.
Embedded in the EHR sidebar, Concordance checks the note the moment it's signed. Because this clinic's payers are on the network, it's matching against Aetna-MA's real rules, not a public guess.
ASSESSMENT
Patient presents for intensive outpatient treatment of moderate alcohol use disorder (F10.20). Reports reduced cravings and improved sleep since last session.
PLAN
Continue group therapy 3×/week. [ medical-necessity justification — not documented ] [ measurable treatment-plan goal — not documented ]
No EHR swivel-chair. No separate dashboard to babysit. The fix happens where the documentation does.
Everything the last tool got wrong, fixed.
Built around the design requirements buyers described themselves — pre-billing, embedded, payer-aware, and accurate enough to trust.
Pre-billing, point-of-care flagging
Gaps surface the moment a note is signed — not after a denial. Clinicians can't move on until medical-necessity requirements are met.
Payer-specific rule engine
Different payers, different language. Concordance knows Aetna-MA from a state Medicaid MCO — down to the Golden Thread and progress-measurement formats.
Deep EHR integration
Native Athena & eClinicalWorks, FHIR-native everywhere else via aggregators. No duplicate work, no messy data flows. Integration is the gate — we clear it.
Agentic AutoFix
One click drafts the missing language and corrected codes in the EHR, ready for clinician approval. Human-in-the-loop on every change.
Quantified exposure dashboard
CFO-grade numbers: clawback exposure by provider, payer and code, plus FTE hours recovered. The business case writes itself.
Accuracy you can trust
Benchmarked to a ≥90% precision bar with a low false-positive rate — because alert fatigue is what killed the last vendor, not the price.
Built first for behavioral health & SUD compliance teams.
IOP/PHP medical necessity, Medicaid managed care, 42 CFR Part 2 — the most complex, highest-enforcement rule sets in the market, and the most underserved. If you're a QA Lead, Compliance Manager, or Revenue Cycle Director living the audit cycle, this was designed around your Monday morning.
"We are still on search for something great." — Health Administrator, Outpatient Behavioral Health
Illustrative model based on interview-reported audit impact ($150K–$860K/event) and QA labor (40–60 hrs/week). Your diagnostic returns numbers specific to your charts.
Start free. Pay when the exposure is real.
The diagnostic is free because quantified fear converts better than a sales pitch — and it's how you'll see exactly what's at stake.
Exposure Diagnostic
- Read-only FHIR connect, 3 questions
- 48-hour report on annual clawback exposure
- Top 5 fixable issues, % recoverable
- No sales call required
Cockpit
- Real-time + batch note validation
- Agentic AutoFix in your EHR
- Pre-Adjudication Seal on network payers
- CFO-grade exposure dashboard
- Audit-response packet generation
Payer & Enterprise
- Payer Console + pre-payment quality view
- Rule-publishing & clawback-trigger UI
- White-label API / embedding
- HITRUST, dedicated security review
See your clawback exposure before your next audit does.
Connect read-only, answer three questions, and in 48 hours we'll show you exactly what's at risk across your charts — and how much of it is fixable.
We've found the opening. We're looking for the founder to run through it.
Concordance is a validated, pre-competitive opportunity in a market begging to be served. The product angle is sharp, the wedge is proven, and the moat compounds. What it needs is the right operator-builder to lead it.
Why the conviction is real
The product is self-described by buyers. Five consecutive interviews converged on the same design — pre-billing, EHR-embedded, payer-specific flagging. That's rare signal strength.
The market is pre-competitive at the ground level. Zero interviewees could name Brellium, Charta, or any specialist vendor. The first-mover window is larger than the spreadsheet modeled.
Budget is not the blocker. "The budget isn't really a problem. It's the rest." Solve integration, workflow and accuracy, and the ROI math ($150K–$860K per audit event) closes itself.
The moat compounds and can't be retrofitted. The bilateral Ledger — real adjudication outcomes contributed by payers — is something no provider-only competitor can ever begin to accumulate.
Regulatory tailwind. CMS's Prior Authorization rule now mandates real-time payer–provider data exchange over FHIR. The pipes this business needs are being legally forced into existence.
The founder we're looking for
Ideal backgrounds: VP Revenue Cycle / CCO at a mid-market behavioral health platform · early operator at Brellium / Charta / Adentris / CodaMetrix · repeat healthcare founder with a CDI, coding or denials exit.
If this is you, you'd be early — and you'd own the category.
Founding CEO. NYC / Boston preferred. A 45-day Proceed/Kill sprint, validated demand, and an 18-month path to a category-defining Series A. The opening is real and the clock is running.
Start the conversation →