One data backbone.
Five modules that compound it.
Practice OS is built on the same continuous TiC + HPT ingestion pipeline that powers ReimburseOS. ReimburseOS predicts. Sentry OS prevents. Denial OS fights. Reclaim OS recovers. Leverage OS renegotiates. One backbone. Five modules. Milliseconds per claim.
Six layers, top to bottom.
Single dashboard surface for the practice. Five module pages. Native cross-module deep links — Reclaim OS's flagged claim opens directly in Denial OS; Leverage OS pulls Reclaim OS's pattern data into the leverage memo. Built with Next.js App Router, server components, Tailwind, shadcn/ui, deployed on Netlify.
Each module is a service-layer worker writing to and reading from a shared Postgres event log. Idempotent, horizontally scalable, replayable. Modules subscribe to upstream events — when Reclaim OS flags a CO-97, Denial OS automatically receives a "needs-letter" event.
Anthropic Claude Opus / Sonnet behind every long-form generation: Denial OS appeal letters, Leverage OS renegotiation memos, denial-pattern explainers. Prompt-cached payer playbooks (CARC code → policy citation → boilerplate language) drop per-letter inference cost to ~$0.20 with 90%+ cache hit rate.
ReimburseOS joins TiC MRF (contracted in-network rates) with HPT MRF (estimated_allowed_amount, live since 1/1/25) to produce realized-rate validation. The only known production system cross-checking the two CMS data sources — the differentiator, now baked into Practice OS.
Custom Schema-2.0-native parser, streaming Node workers, gzip-on-the-fly, gracefully handles Anthem's 10.4GB single-line index, Aetna DRG-collapse, UHC PPO/behavioral overlaps. 100K+ rows/hr throughput per worker. Continuous monthly refresh (TiC) + daily (HPT). 26,497 NPIs × 67 CPTs × 30+ payers × 50 states.
CMS Transparency-in-Coverage MRFs (every commercial payer, federally mandated since Jul 2022). CMS Hospital Price Transparency MRFs (every hospital, mandated since Jan 2021, with realized-rate fields since Jan 2025). NPI Registry. NCCI edits. LCD/NCD policies. CARC/RARC code dictionaries.
A single claim, traced end-to-end.
[1] Claim drafted in EHR (eClinicalWorks) ↓ webhook fires on save [2] Sentry OS reads draft ↓ joins NCCI edits + LCD policies + payer history ↓ predicts denial probability per CPT [3] ReimburseOS joins TiC + HPT ↓ contracted rate $94.20 · realized p50 $89.40 · expected revenue line [4] If denied (CO-97 returned via 835) ↓ Denial OS event fires ↓ Claude generates letter (5m, $0.20) ↓ letter packet routed to faxer / portal / mail per payer playbook [5] On payment posting (835 EOB) ↓ Reclaim OS joins paid amount vs contracted rate ↓ if delta > $5 → flag for sweep ↓ batched recovery filing per payer cadence [6] Leverage OS aggregates over rolling 12mo ↓ underpayment patterns by payer × CPT × geography ↓ generates leverage memo for next contract renewal ↓ peer-rate benchmarks pulled from full TiC backbone Total round-trip on a single claim: instrumented in 5 places. Auditable. Replayable.
Built for HIPAA from line one.
Walk the architecture, in the demo.
Every layer instrumented. Every event traceable. Every dollar accounted for.
Open the demo platform →