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, and insurer correspondence.
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
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.
Two Systems
Two Outcomes
Highly capable teams are operating inside a claims and appeals system designed by insurers.
It appears neutral. It appears procedural. It appears fair.
It isn’t.
Insurers operate within one system: Precision. Specificity. Rule fluency.
Providers are forced into another: Ambiguity. Reaction. After-the-fact justification.
These two systems do not — and cannot — produce equal outcomes.
This is not a pain point.
It is a chronic, structural condition.
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
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Strategic guidance and oversight from Dr. Ludwick, the physician behind the platform
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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.
This Is For Leaders Who Want to Operate on Offense
OutClaim is designed for specialty physician groups and
revenue leaders who:
Know the care was appropriate
Are tired of budgeting around insurer uncertainty
Want control earlier in the process — not better excuses later
If your goal is faster appeals, this may not be a fit.
If your goal is predictable payment, it will be.
Stop Playing Defense
Stop Playing Their Game.
Start Winning Yours.
Preempt. Obligate. Get Paid.
Start Winning Yours.