Frequently Asked Questions

Proof of Value — General

  • Most practices do not have visibility into the full picture of what is denied, why it is denied, and what is actually recoverable. Billing staff work reactively — one claim at a time — without a structured system to prioritize, act, and defend decisions. Payers are increasingly using automated systems to deny claims faster and with less transparency. The result is significant denied revenue sitting in backlog that is never pursued — not because it is unrecoverable, but because the intelligence to act on it has never existed at the practice level.

    That is exactly what h3alth AI deploys — starting with the h3alth AI Denial Intelligence Platform, which surfaces your denied revenue, your payer behavior patterns, and your recovery opportunity on your real claims and remittance data. Every first-time client begins here.

  • Proof of Value is a structured 90-day engagement where h3alth AI ingests your real claims and operational data, deploys the relevant intelligence platform directly into your environment, and surfaces financial and operational intelligence your team can act on immediately. This is not a trial. It is not a demo. It is a live deployment on your real data — and it costs nothing to start.

  • A demo shows you what a platform can do on someone else's data — usually synthetic or sample data designed to look impressive. A Proof of Value deploys on your real claims and remittance data. What you see is your denied revenue, your payer patterns, your recovery opportunity. Not a simulation. Not an approximation. Your actual numbers.

  • The engagement runs for 90 days. Your team gains access to the Executive Denial Intelligence and Claim-Level Capabilities once ingestion and deployment are complete — with timing scoped based on your data during the first call.

  • The 90-day Proof of Value is completely no cost. No contract, no commitment, no implementation fees, no hidden costs. You see the platform working on your real data before making any long-term financial decision.

  • There is no contract, no commitment, and no obligation to continue after the 90-day engagement. At the end of the POV, we review results together. If value is proven and you want to move to production deployment, we discuss what that looks like. If you decide it is not the right fit, there is no penalty and no obligation.

  • We review results against the success criteria defined at the start — recovery impact, executive clarity, and staff efficiency. We present what the platform surfaced, what was recovered, and what the ongoing opportunity looks like. If value is proven, your platform transitions to full production deployment. If you decide not to continue, we close the engagement and delete your data upon request with confirmation.

  • Success criteria are the measurable outcomes we agree on upfront before the engagement begins — recovery targets, time-to-recovery benchmarks, and priority denial categories. The h3alth AI team defines a recommended set based on your practice profile. The success criteria are formulated in partnership and you approve them before anything begins.

  • Yes to both. If you need more time, extensions are available on a case-by-case basis at no cost. If you want to stop early, you can at any time with no penalty. We close the engagement, present results to that point, and delete your data upon request with confirmation.

  • The Proof of Value does not interfere with any existing vendor relationships or contracts. h3alth AI deploys read-only on your data and sits above your existing relationships. You are not switching anything. You are not violating any existing contract. You are adding an intelligence layer on top of what you already have.

  • Yes — and it is encouraged. Leadership and practice owners engage with the Executive Denial Intelligence experience. Billing staff and revenue cycle teams engage with the Claim-Level Capabilities experience. Both can be active simultaneously during the POV.

  • Before the Proof of Value begins, h3alth AI and the practice sign two documents — a Business Associate Agreement covering HIPAA-compliant data handling, and a Proof of Value Agreement outlining the scope, success criteria, data handling terms, and the no-cost nature of the engagement. Both are provided before any data is shared. Nothing begins without fully executed agreements in place.

    The decision sequence is simple — confirm fit on the first call, execute agreements, deploy on your data, review results at 90 days, then decide on production.

  • The right fit is a practice that has denied revenue in backlog it is not fully recovering, a billing team or outsourced billing relationship working with claims data, and leadership that wants financial visibility into what is actually happening — not a summary from a billing report. If those three things are true, the Proof of Value will surface something meaningful. The first call is designed to confirm fit before anything begins.

Proof of Value — The Deployment

  • The primary data inputs are your claims and remittance data — specifically EDI 835 remittance files, EDI 837 claim files, CSV exports from your billing system, EOBs, and denial letters in PDF format. If you have some but not all of these, we work with what you have. Our team will walk you through exactly what is needed on your first call.

    That is exactly what h3alth AI deploys — starting with the h3alth AI Denial Intelligence Platform, which surfaces your denied revenue, your payer behavior patterns, and your recovery opportunity on your real claims and remittance data. Every first-time client begins here.

  • Data ingestion is handled through a structured white-glove process. You provide your data files through a secure transfer method. The h3alth AI team handles everything from there. You do not need to connect any systems, grant API access, or involve your IT team.

  • Not during the Proof of Value. The POV ingests data from file exports your existing systems already produce — EDI files, CSVs, PDFs. No direct integration, no API connection, no changes to your current systems. The deployment is fast, low-risk, and requires nothing from your IT team.

  • Deployment timeline is scoped based on your data volume and format after our first call. Our team will give you a specific estimate before anything begins so you know exactly what to expect.

  • From your team's perspective, deployment is invisible. You provide your data files. The h3alth AI team does the ingestion, normalization, and deployment work behind the scenes. Your team's first involvement is accessing what the platform surfaces — where the value of deploying on your real data becomes immediately clear.

  • No. Leadership accesses their Executive Denial Intelligence experience and staff accesses their Claim-Level Capabilities experience independently — both are fully self-serve and designed to be immediately actionable from day one. No onboarding sessions, no training materials, no learning curve.

  • No. h3alth AI deploys read-only above your existing systems. Nothing in your current billing workflows, EHR, or outsourced billing relationships changes. The platform surfaces additional intelligence and guidance — it does not replace or disrupt any existing process.

  • This is worth discussing on your first call. Some outsourced billing relationships retain all claims data on behalf of the practice. Our team will work with you to identify what data is accessible and whether a modified ingestion approach is possible. It is not automatically a disqualifier — but it is something to surface early.

Proof of Value — Data & Security

  • h3alth AI runs on HIPAA-compliant Microsoft Azure infrastructure. Your data is encrypted at rest using AES-256 and in transit using TLS 1.2 or higher. Every practice is provisioned into its own isolated environment — your data never touches any other practice's data. Role-based access controls, complete audit logging, and enterprise-grade security controls are enforced at the infrastructure level from day one. Microsoft Azure maintains SOC 2 Type II certification, ISO 27001 certification, and HIPAA compliance attestation. Documentation is available upon request.

  • Yes. h3alth AI signs a Business Associate Agreement with every practice before any data is shared. The BAA covers the full scope of the Proof of Value engagement and all PHI handling.

  • Yes. h3alth AI maintains commercial-grade cyber liability and HIPAA-related insurance coverage. This provides an additional layer of protection beyond the technical safeguards of our Azure infrastructure. Details are available upon request as part of your due diligence.

  • You do. Your data belongs to your practice. h3alth AI processes your data only for the purpose of deploying the platform and surfacing intelligence during the engagement. We do not sell your data, share it with third parties, or use it for any purpose outside of your engagement.

  • h3alth AI deletes all of your data upon request with confirmation of deletion. Nothing is retained.

  • Access is strictly limited to the h3alth AI team members directly involved in your deployment. Role-based access controls on the Azure infrastructure enforce these limits technically — it is not just a policy, it is enforced at the infrastructure level.

  • Yes. Our team can walk your IT team through the full security architecture — Azure infrastructure, HIPAA compliance posture, data isolation design, encryption standards, and audit logging. This conversation typically happens as part of the first meeting or as a follow-on technical call.

Proof of Value — What you Receive

  • Leadership receives access to the Executive Denial Intelligence experience — real-time visibility into open balances and total denied dollars, recoverable revenue already sitting in the denial backlog, top denial drivers by payer and procedure, week-over-week trends and 30–90 day priorities, and continuous visibility into where payer behavior is shifting.

  • Billing staff receive access to the Claim-Level Capabilities experience — instant access to any denied claim with a clear explanation of what happened and why, exact next steps for correction, resubmission, or appeal, and every recommendation evidence-linked to the specific claim ID, denial code, denial date, and billed versus paid amounts. Every output is a payer-ready artifact they can act on immediately.

  • Every denied dollar figure is computed deterministically from your real claims and remittance data using structured, rule-based logic. Billed greater than paid equals denied. Paid equals zero equals actionable. These are not estimates or model outputs. They are mathematical facts derived directly from your source files — reproducible, auditable, and traceable back to a specific claim.

  • At deployment h3alth AI establishes a baseline of your payer behavior — denial rates by payer and procedure code — using your historical claims data. The platform then continuously monitors for deviations, surfacing shifts in payer behavior before they quietly impact your revenue. Most practices have never had this visibility before. It is one of the most valuable things the POV surfaces.

  • Once deployment is complete, the platform surfaces the total dollar amount of denied revenue sitting in your backlog and the subset that is recoverable — computed from your real data, not estimated.

  • Once the Claim-Level Capabilities experience is live, your billing staff can begin working denied claims immediately using structured, evidence-linked guidance. Recovery during the POV counts toward your success criteria.

  • That is valuable information too. It means your current denial management is performing better than average, or that your payer mix has different characteristics than typical practices in your specialty. Either way you have a clearer picture of your financial position than before — and the dollar value of what is surfaced, however large or small, is computed from your real data and defensible to any stakeholder. The payer behavior baseline continues monitoring for future shifts regardless of initial recovery size.

  • Yes. At the end of the 90-day engagement the h3alth AI team presents a structured review of results against the success criteria defined at the start — total denied revenue surfaced, recovery achieved, payer behavior patterns identified, and a forward-looking picture of the ongoing opportunity. You receive documentation you can share with your leadership team.

Proof of Value — After the Engagement

  • Production deployment transitions the platform from the 90-day POV to a continuously running intelligence system — the same platform, data, experiences, and payer behavior monitoring operating on your data indefinitely. Ongoing denial monitoring, payer change detection, recovery support, and prevention optimization are all included.

  • When a practice transitions from the Proof of Value to production deployment, h3alth AI and the practice sign a Master Services Agreement — the formal agreement governing the ongoing platform relationship. The MSA covers platform access, data handling, security obligations, pricing, support terms, and commercial terms. Nothing moves to production without a fully executed MSA in place.

  • Production deployment pricing is based on practice size and deployment scope and is discussed after value is proven during the Proof of Value. Production deployment is structured as a straightforward annual platform relationship — scoped to your practice after value is proven.

  • The h3alth AI team remains actively involved after production deployment via Premium Support at no additional cost. This is not a software-as-a-service relationship where you are handed a login and left alone. h3alth AI continues to monitor your deployment, surface insights, and support your team. The level of ongoing involvement is defined in your Master Services Agreement.

  • Yes — and this is the intended path. Once the Denial Intelligence Platform is in production, the same structured POV motion applies to the next capability. The Compliance Audit Intelligence Platform and Practice Clarity Intelligence Platform both deploy on the same deterministic data foundation already established — making expansion faster and lower friction than the initial deployment.

  • h3alth AI does not require long-term lock-in contracts for early clients. Terms are structured to be fair and flexible — because the goal is to earn your continued business through ongoing value, not contractual obligation.

  • That conversation happens directly with the h3alth AI team. If your needs change, your deployment can be adjusted. The terms of the Master Services Agreement cover these scenarios explicitly.

  • h3alth AI has contingency protocols to ensure your engagement is not disrupted in the event of an unexpected absence or operational issue. These protocols are discussed as part of the production deployment agreement.

Doing business with h3alth AI

  • Most denial management tools use AI models to estimate what might be denied and generate generic appeal letters. The output is a guess — it cannot be traced back to a specific claim, verified against source data, or defended to a payer. h3alth AI computes denial truth deterministically from your real claims and remittance data. Every output traces back to a specific claim ID, denial code, denial date, and billed versus paid amounts. It is auditable, reproducible, and defensible — not probabilistic. Beyond the architecture, h3alth AI deploys on your data without replacing your existing systems or billing relationships. It is intelligence on top of what you already have — not a replacement for it.

  • h3alth AI is a founder-led healthcare intelligence company headquartered in Downtown Sarasota, Florida. h3alth AI is defining a new category — Provider Financial Intelligence — platforms deployed directly on healthcare practice data to surface financial and operational intelligence that practices have never had access to before. The h3alth AI team brings together enterprise-grade engineering and healthcare domain expertise to build and deploy the platform.

  • h3alth AI is a founder-led company in its go-to-market stage. Every client engagement is led personally by our founder, supported by an engineering and technical team with enterprise-grade capabilities. This founder-led model is deliberate — it means every engagement gets direct senior attention, fast deployment, and a high standard of quality. As h3alth AI scales, the team will grow alongside it.

  • The infrastructure h3alth AI deploys on is enterprise-grade — HIPAA-compliant Microsoft Azure with full encryption, access controls, audit logging, and data isolation. The company may be in its go-to-market phase but the infrastructure, the engineering, and the compliance posture are not. h3alth AI also maintains commercial-grade cyber liability and HIPAA-related insurance coverage. Our team can walk you through the full security architecture and insurance posture in detail before any data is shared.

  • No. Florida is h3alth AI's priority market but the platform is available to healthcare practices across the United States. If you are outside Florida and interested in a Proof of Value, reach out and our team will discuss whether your practice is a fit.

  • h3alth AI works with small to mid-size healthcare practices across procedural specialties — orthopedics, cardiology, oncology, gastroenterology, neurology, surgery centers, and multi-specialty groups. If your specialty is not listed, reach out — our team will assess whether your practice is a fit.

  • The sweet spot is practices with 5 to 50 providers. If you are outside this range, reach out — our team will assess fit on a case-by-case basis.

  • No. h3alth AI deploys read-only on top of your existing billing relationships. Your billing company continues handling claims processing and workflow. h3alth AI surfaces the intelligence and guidance your billing company and internal team do not currently have visibility into. It is additive, not a replacement.

  • No. h3alth AI ingests data from the file exports your existing systems already produce — EDI files, CSVs, PDFs. No system changes, no integrations, no IT involvement required.

  • h3alth AI is in its go-to-market stage. Our team can speak to technical validation and architecture in detail. As POV results are completed and clients transition to production, case studies and outcome data will be made available. If references are important to your evaluation, raise it on your first call — our team will be transparent about where the company is and what validation is currently available.

  • The simplest framing is this — h3alth AI deploys on our real claims data at no cost for 90 days and surfaces exactly how much denied revenue we have in backlog and what it would take to recover it. Success criteria are defined upfront. Results are measured against those criteria. There is no contract, no new software, and no disruption to our current workflows. The only decision right now is whether a 30-minute first call is worth our time.

  • Fill out the form on the Contact or Proof of Value page and our team will follow up within 24 hours to schedule a 30-minute first meeting. In that meeting we will learn about your practice, walk through how the Denial Intelligence Platform works, and determine whether a Proof of Value is the right next step. No cost, no commitment, no pressure.

You've done your diligence. Now see it on your data.

Start with a no-cost 90-day Proof of Value — deployed on your real data with no disruption to your current systems.

Submit the form and we'll follow up within 24 hours to review your practice and next steps.

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