Trust
How Upheld is designed to operate
Clinical Revenue Integrity is not coding theater and not a CMS grouper. Every finding is advisory until a clinician or QA owner acts.
Human-in-the-loop
AI surfaces and prioritizes. Clinicians and QA accept, dismiss, or correct.
Findings never auto-write to an EMR or claim system in Free Chart Scan.
PHI & BAA
Prefer de-identified or synthetic packets for Free Chart Scan until a Business Associate Agreement is signed.
Free scan retention is time-limited. Agency settings track BAA posture (none / pending / signed).
We do not train base models on customer PHI without explicit, documented consent.
Capture vs protect dollars
Capture — potential revenue if documentation supports additional coding/comorbidity accuracy (not upcoding beyond the record).
Protect — exposure if the chart is submitted with denial, LUPA, or compliance gaps.
Both are advisory estimates anchored to CMS national standardized rates.
CMS CY 2026 rate anchors
National standardized amounts · not a remittance or grouper
30-day period base
$2,038
Quality data submitters
SN per-visit (LUPA)
$177
PT $193
Illustrative LUPA gap
$1,153
Period − (5 × SN) · view protect issues
CMS CY 2026 HH PPS Final Rule (CMS-1828-F) — national standardized 30-day period & per-visit rates. Actual payment = base × case-mix weight × wage index. Upheld estimates are advisory only.
Abuse controls & retention
Free Chart Scans are rate-limited per email, network, and agency to prevent abuse.
Free scans expire after a configurable retention window and can be purged via scheduled job (expired FREE type only — pilot/full history is retained).
Encryption & infrastructure
Chart text and evidence excerpts can be encrypted at rest (AES-256-GCM) when field encryption is enabled in the environment.
Hosting: Vercel · Database: Neon Postgres · Email: Resend · OCR (scanned PDFs): Azure Document Intelligence. Complete BAAs with each subprocessor before identifiable PHI production use.
Paid pilot checkout (Stripe) is optional and currently deferred — pilot interest is collected by form and email only.
Live platform status: /status. How scores and dollars are computed: /calculations.
What we are not
- Not an EMR or system of record
- Not a certified CMS HIPPS grouper
- Not outsourced coding that replaces clinical judgment
- Not “QA software” theater disconnected from dollars
30-day pilot
Request a pilot
Submit this form and we’ll email you back. Your request also goes straight to our team. No credit card.