It's a strategic failure.
OutClaim is a claims enforcement platform designed to get healthcare organizations paid — pragmatically, consistently, and at scale
When you engage OutClaim, you engage a physician-built strategic framework for insurer engagement, developed over 15 years of successful reimbursement experience, the system dynamically generates case-specific strategies using AI as the delivery mechanism.
OutClaim removes insurer interpretation and discretion by replacing ambiguity with specificity, opacity with transparency, and requests with obligation.
OutClaim is easy for your billing staff to use and fits into your existing workflow. Minimal setup and no disruption. Monthly fees as low as $50 and early bird pricing on pre-service and appeal strategies.
This is not about fighting insurers. It’s about removing their ability to reinterpret your work.
We help providers play the game better — by flipping the script on who’s in control
Game On
Stop Asking. Start Establishing Obligation
Apply for early access to OutClaim
OutClaim turns complex insurer policies, ERISA requirements, and standards of care into enforceable written correspondence — automatically, consistently, and at scale
See OutClaim in action.
In a short, working demonstration, see how OutClaim fits into your existing workflow — without system integrations, long-term commitments, or retraining your team
No disruption. No retraining. No long‑term contracts. Just clarity — from the beginning
Early‑access pricing available. No obligation
The Battle Is Lost Before It Begins
This isn’t because provider teams are underperforming
Highly capable billing and revenue cycle teams are operating inside an insurer-designed system that:
Withholds clarity
Controls timing
Reserves interpretation power
Revenue loss doesn’t happen at the denial
It happens upstream — when vague records, verbal assurances, and insurer-controlled processes define the engagement
Over time, provider billing teams are conditioned to:
Accept ambiguity
Chase information they should have access to
React after leverage is gone
Insurers, by contrast, operate with precision — using delay, vagueness, invented processes, and burden-shifting to control outcomes
The result?
An insurer-defined response loop — they define the moves, providers are trained to react
It’s predictability — in their favor
Built on Authority, Not Templates
OutClaim replaces reactive claims behavior with a proactive, authority-based engagement model
At a high level, OutClaim:
Acts pragmatically
by creating strategies that get providers paid and puts providers in a position of leverage
Creates transparency
by obligating insurers through insurer-specific, written records, grounded in governing rules and clinical authority
Establishes accountability
by enforcing insurer disclosure and compliance requirements — eliminating interpretation in favor of existing rules and the law
The correspondence doesn’t ask for approval
It establishes obligation
No templates
No opinions
No grey areas
Just clarity — from the beginning
More Than a Platform: Expertise, Strategy, Consulting
-
Strategic guidance and oversight from Dr. Ludwick, the physician behind the platform
-
Coaching
on how to think differently about insurer engagement -
Support
in shifting teams from defensive habits to an offensive posture
Why This Was Never Fixed (Until Now)
The rules requiring insurers to be specific, transparent, and accountable have always existed
What was missing:
Knowledge — most providers have never heard of ERISA or do not understand how
to use it properly; they’re often simply unaware of all the strategies available to them. OutClaim provides the knowledge and proper application.
Billers and staff are using the wrong playbook — they’ve been conditioned by the insurance companies to show them how to get paid, how to appeal, how to obtain authorizations, etc., all defensive strategies. OutClaim provides the offensive playbook designed to get providers paid.
Even if the knowledge and correct playbook were being used, it would be impossible to apply at scale. OutClaim changes all of that.
The system didn’t change
The leverage did
OutClaim Is For Leaders Who Want to Operate on Offense
Designed for specialty physician groups and revenue leaders who want control earlier in the process and are tired of budgeting around insurer uncertainty.
If your goal is predictable payment, OutClaim is for you.
Stop Playing Defense
Stop Playing Their Game
Start Winning Yours
Preempt. Obligate. Get Paid.
Start Winning Yours