Pre-payment compliance for behavioral health

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

BUILT FOR THE WORKFLOW BEHAVIORAL HEALTH COMPLIANCE TEAMS ACTUALLY RUN
HITRUST track SOC 2 · HIPAA Athena eClinicalWorks FHIR-native 42 CFR Part 2
$150K–$860K
Operational impact of a single payer audit event — confirmed across buyer interviews.
90%+
of charts go unaudited today. Only 5–10% are reviewed before billing.
40–60 hrs
per week a QA lead spends in Excel, comparing notes to payer criteria by hand.
1–2×/mo
Payer audit cadence. This is a chronic operating condition — not a rare event.
The problem

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.

Every payer wants different language. Medical-necessity framing, Golden Thread links, progress-measurement formats — clinicians document blind to it.
Review happens after the claim, not before. 90%+ of charts are never checked until a denial or recoupment forces it.
Your EHR can't help. No medical-necessity scoring, no payer-specific rules, no missing-language alerts. So it falls on your QA lead and a spreadsheet.
One clawback becomes a multi-week fire. Cross-team remediation, trust breaking down between clinical and billing, and yes — job-security anxiety.
"
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.
CS
Chief Strategy OfficerBehavioral Health Treatment Group
"
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.
HM
Healthcare ManagerMultispecialty Behavioral Health Org
How Concordance works

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.

FOR YOUR TEAM

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.

FOR THE PAYER

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 ENGINE

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.

The Pre-Adjudication Seal

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.

Checked against live payer rules — not scraped CMS manuals.
A signed validation record the payer's adjudication system recognizes.
Auto-assembled audit-response packet from sealed-chart evidence, if a question ever arises.

Sealed

This chart satisfies Aetna-MA's published rules.
It will not be clawed back.
Pre-Adjudication Seal · verified
Product demo

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.

STEP 1 / 5 · POINT OF CARE

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.

app.concordance.health / cockpit / chart · 48213 EHR SIDEBAR · LIVE
Progress note · IOP Payer: Aetna-MA

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.

What's inside

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.

Who it's for

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.

IOP / PHP medical necessity 42 CFR Part 2 (SUD) Medicaid managed care Golden Thread linkage Multispecialty behavioral health Outpatient mental health 10–100 clinician groups
"We are still on search for something great." — Health Administrator, Outpatient Behavioral Health
Illustrative annual ROI · 30-clinician group
Clawback exposure prevented+ $195,000
QA labor recovered (≈1.5 FTE)+ $120,000
Denials avoided / cash-flow lift+ $74,000
Concordance subscription− $96,000
Net annual impact≈ $293K

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.

Pricing

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

Find out what's at risk
Free
  • Read-only FHIR connect, 3 questions
  • 48-hour report on annual clawback exposure
  • Top 5 fixable issues, % recoverable
  • No sales call required
Run my diagnostic
MOST POPULAR

Cockpit

For 10–100 clinician groups
$8K–$15K / mo
  • Real-time + batch note validation
  • Agentic AutoFix in your EHR
  • Pre-Adjudication Seal on network payers
  • CFO-grade exposure dashboard
  • Audit-response packet generation
Book a walkthrough

Payer & Enterprise

Payers & 100+ clinician networks
Custom
  • Payer Console + pre-payment quality view
  • Rule-publishing & clawback-trigger UI
  • White-label API / embedding
  • HITRUST, dedicated security review
Talk to us
Get started

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.

Build with us

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.

$4.4–6.0B
Total addressable market across clinical documentation compliance.
$537–665M
Serviceable market in the beachhead — behavioral health & multispecialty.
5 / 5
Buyer interviews independently described this exact product, unprompted.
6–7-fig
Payer-side ACV — a 10–50× buyer once the bilateral network turns.

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

A revenue-cycle or compliance operator turned builderYou've owned a QA, CDI or denials P&L and lived through a six-figure clawback firsthand.
Fluent in the domain, not just adjacent to itIOP/PHP medical necessity, 42 CFR Part 2, Medicaid managed-care audit triggers — you can speak them without notes.
Procurement-savvy across the two-track saleYou can win the operational champion and write the CFO-grade ROI case that unlocks budget.
Technical enough to govern a 90%+ precision barYou can interrogate a CTO on FHIR, hallucination mitigation and per-chart inference economics.
If you can stand on the payer side of the tableThe unfair advantage is landing the anchor payer. An insurance-world insider opens that door in months, not years.

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