AI Claim Integrity Platform |
Healthcare Revenue Cycle Software

Grelin Health is a healthcare AI company that builds the platform for Claim Integrity. The platform validates that claims are correct, complete, and defensible before submission and audits them before payment. It serves payers, providers, pharmacy distribution, and government programs.

Four applications on one platform. RxAI validates pharmacy claims across the distribution supply chain. Audit.ai audits claims for payers before payment. RCM.ai validates provider claims before submission. Chart.ai turns clinical documentation into defensible claims, with specialty modules for wound care, pain management, behavioral health, and durable medical equipment.

Health plans and payers that audit claims. Provider organizations that submit them. Pharmacy distributors that move claims across networks. Technology companies that embed validation into their own platforms. Each group runs a different application on the same underlying platform.

No. The platform takes over the manual review work machines do better, like checking a claim against payer policy line by line. Billing teams keep the judgment work: exceptions, appeals, and payer relationships. The goal is fewer claims that need rework, not fewer people.

Grelin sits alongside existing systems rather than replacing them. It reads from the electronic health record, practice management, or claims system, runs its checks, and returns results into the existing workflow. Deployment can be direct or embedded inside a partner platform.

A scrubber checks format and basic edits at submission. Grelin validates substance: whether documentation supports the codes, whether the payer's specific policy is met, whether eligibility holds. A scrubber catches a missing field. Claim Integrity catches a claim that is clean on format and wrong on content.

Software. The applications are licensed annually and run inside the customer's or partner's workflow. Grelin does not take over billing operations or staff them. The product is validation logic, applied earlier in the claim lifecycle than existing tools reach.

Grelin uses AI to read clinical documentation, apply payer-specific policy, and check claims at volume. Every automated verdict carries its reasoning, and exceptions route to human review. AI is the mechanism that makes early validation possible at scale. The product is the validation.