Alexander SaaES + Collaborator | Beyond Health Systems published a 2025 American Hospital Association estimate of $43 billion spent in U.S. hospitals trying to collect payments insurers already owed for care delivered, including $18 billion overturning claims denials.

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HOSPITALS ARE BEING HIT TWICE: first losing billions in earned revenue, then spending billions trying to recover it. Boards and C-suites have accepted these economics fo…

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About Alexander SaaES + Collaborator | Beyond Health Systems

Beyond-Claims™ is the end-to-end claims automation platform that prevents denials before first submission and autonomously fixes the rest—so providers, hospitals, and RCM/HIM teams get paid faster at pennies per claim. Built with Beyond-AI’s engineering brilliance, it runs inside your environment, keeps PHI in your perimeter, and returns clean outputs to your EHR/clearinghouse with full auditability. Key capabilities Preemptive Denial Prediction — flags high-risk claims and surfaces payer-specific fixes (coding, modifiers, attachments) before first pass. Autonomous Resolution — detects denials, applies proven corrections, and generates submission-ready 837 resubmissions. Full 835/837 Parsing & Normalization — 100% segment capture from raw EDI into standardized CSV + FHIR JSON. Denial Enrichment — CARC/RARC descriptions, payer notes, specialty overrides, and lookup tables (CPT, ICD, POS). Dual Format Outputs — parallel EDI & FHIR for clearinghouses and EHR workflows. Simulation Engine — mock payer logic validates claims pre-submission to avoid repeat denials. Audit Logging — immutable, line-level logs for every adjustment and override; HIM-ready. BeyondDocmatch™ — links documents to claims via proximity/fuzzy matching for rapid evidence and appeals. CMS Integration — compliance checks and pre-submission validations. Result: fewer first-pass denials, dramatically less rework, faster cash, and complete transparency. Private Beta is open—partners, pioneers, and early acquirers welcome.

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