Strategic Overview

The Missing Layer
Before Your Platform

Same note. Same codes. Every time. Zero PHI exposure. The clinical extraction logic that doesn't exist anywhere you can buy it.

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The Problem

Where data quality breaks down

The note is the source of truth. But between the note and the claim, there's a gap — manual coding, weak auto-suggest, or nothing at all. Everything downstream inherits that gap.

Step 1Patient Encounter
Step 2Doctor Writes Note

Unstructured narrative in EHR (Epic, Cerner, etc.)

Step 3Note → Codes

Manual coder, weak EHR auto-suggest, or no coder at all.

The extraction gap
Step 4Coded Claim Sent to Waystar

Missed specificity, wrong codes, missed HCCs, vague documentation

Step 5Waystar Submits to Payer

Scrubbing + edits catch format errors — but can’t fix bad codes

Step 6Payer Adjudicates

15% denied. $25–40 rework per denial.

Integration

Can I integrate this?

Yes. One API endpoint. No workflow changes. PHI never leaves your network.

Split-Pipeline Architecture

Stage 1 runs on-device (entity extraction, PHI containment). Stages 2–4 run on our cloud via API. Your data stays in your network. Our IP stays in ours.

Single API Endpoint

POST a PHI-free intermediate representation, receive structured claim-ready JSON. Already built, tested, deployed on Google Cloud Run.

Any Input Source

Epic, Cerner, fax, OCR, dictation, wall-of-text. The engine normalizes and extracts from whatever you feed it. No EHR dependency.

No Workflow Change

Runs in parallel with your existing pipeline. Compare our output against what you currently receive. Zero disruption to production.

Under 2 weeks to pilot. We ship a thin client for Stage 1. You point it at notes. Results flow through our API. You compare against your current output.

Regulatory & Compliance

Can I defend this to regulators?

Every output is traceable, reproducible, and evidence-backed. No black boxes. No hallucinated codes. No PHI exposure.

Deterministic & Reproducible

Same note, same codes, every time. Output verified with SHA-256 hash comparison across runs. No model drift, no retraining instability, no stochastic variation.

Zero PHI in Cloud

Three-layer fail-closed egress gate. Clinical notes are structurally transformed into SNOMED concept documents — not redacted, not masked. The rebuilt document preserves clinical meaning with zero patient identifiers.

Full Decision Trace

Every code has: the sentence that supports it, the assertion proof, the family resolver path, the suppression evidence, and the tier classification reason. Auditors can trace any output back to the note.

Engine-First, AI-Gated

90%+ of output is deterministic rules. The AI layer (∼10%) can only propose — it cannot change billing. Every AI suggestion is validated by the engine before surfacing. The AI never sees PHI.

“Run the same note 100 times. Get the same codes 100 times. No AI-first system can make that claim.”

Replacement Cost

How long to build this ourselves?

43 core modules. 5 pipeline stages. 2+ years of clinical engineering. CMS publishes codes. SNOMED publishes the ontology. The decision logic that connects them doesn't exist anywhere you can buy it.

6–12 months
574K-Concept Matching Engine

Semantic-tag gated SNOMED index, abbreviation expansion, section-aware matching, 6-signal candidate scoring

12–18 months
50+ Family Resolver Tables

Multi-axis code resolution for every major ICD-10 family. Heart failure alone has 12 codes across 2 axes with HCC boundary guards

6–9 months
PHI-Safe Semantic Rebuilder

Structural transformation (not redaction) that preserves clinical meaning. Three-layer fail-closed egress gate

6–12 months
Clinical Relationship Graph

4.4M SNOMED relationships wired into O(1) query API. 851 explained-by pairs, acuity variants, complication chains

6–9 months
Evidence & Tier Architecture

Per-entity evidence annotation, 5-tier classification, entity dossier builder, assertion detection operator algebra

3–6 months
Testing & Validation Suite

255 integration tests, 19 golden tests, blind evaluation, reproducibility verification, adversarial audit

2–3 years · 3–4 engineers + clinical informaticist

And that assumes you know what to build. The clinical edge cases — dictated notes, assertion scoping, family axis resolution, HCC hierarchy conflicts — are discovered through thousands of test notes, not designed upfront.

Strategic Risk

What if a competitor gets this?

You own Iodine (during encounter) and the claim lifecycle (AltitudeAI). The extraction layer between them is the one piece you don't control.

Layer 1: During EncounterYou own this

Iodine (Yours)CDI. Improves documentation while the doctor writes.

Layer 2: Post-Encounter ExtractionGap

VMC (The Gap)Turns the finished note into claim-ready codes. Deterministic. Any input source.

Layer 3: Claim LifecycleYou own this

Waystar Platform (Yours)Scrubbing, submission, denial management, appeals. 6B transactions/year.

If someone else acquires this

Instant 2–3 year leap

A competitor that was years behind now has 43 production modules, 50+ family resolvers, and a PHI-safe AI architecture — deployed.

Shipped product, not just code

They get an Electron app, a cloud API, and a tested pipeline. They can offer extraction to their clients in weeks, not years.

Clinical logic transfer

574K concept mappings, 851 suppression rules, 4.4M graph relationships. The decision logic that took 2+ years to build walks out the door.

They introduce a layer nobody knows exists

Right now, no one in the market knows the extraction layer is a solvable problem. A competitor who acquires this doesn’t sell it as a product — they embed it. Every garbage note across their entire platform starts producing better data. Their denials drop. Their first-pass rates climb. And you’re still feeding AltitudeAI the same incomplete input.

If Waystar owns this

Close the stack

Iodine improves the note. VMC extracts the codes. Waystar processes the claim. End-to-end, one platform.

Better data into AltitudeAI

Extraction quality feeds directly into denial prevention, charge integrity, and appeals. Cleaner input, fewer denials.

30,000 clients, day one

Platform-level deployment. Every Waystar client gets better first-pass acceptance without buying a separate tool.

No competitor can replicate this

You own all three layers. The only company with CDI + extraction + claim lifecycle under one roof.

Validation

Pre-commercial. Production-validated.

0
critical false positives
100%
reproducible output
574K
concepts indexed
851
suppression rules
50+
family resolvers
<2s
per-note extraction

The Ask

Industry average: 15% initial denial rate. $25–40 rework cost per denial. A 5% denial reduction across 30,000 clients is measurable in the first 30 days.

A 30-day parallel run on notes already flowing into your platform.
Our extraction alongside whatever you currently receive.
You see the delta. No commitment until you see data.

No workflow disruption·No process change·Under 2 weeks to integrate