How much does Claim Health cost?

There is no public pricing; Claim Health is sold to post-acute agencies through demos.

What are the best alternatives to Claim Health?

Based on documented capability coverage across the Agentic Index 14 point taxonomy, the closest alternatives to Claim Health among healthcare agents are AlethianAI, Adonis, Charta Health, DeepCura. Each is graded on the same public evidence, and no vendor pays for placement.

Does Claim Health require human approval before an agent acts?

Full under the Agentic Index verification standard. Claim Health publishes public evidence of human approval steps and guardrails, so an agent action can be held for review before it executes. Evidence basis: Routine posting, reconciliation and follow-up are automated while exceptions are surfaced to the billing team for review before they are resolved, so teams handle only the exceptions rather than every claim, and intake gaps are surfaced bef. Graded from public evidence only against the Agentic Index 14 point capability taxonomy. No vendor pays for placement.

Does Claim Health have SOC 2, SSO and role based access control?

Partial under the Agentic Index verification standard. Claim Health publishes some public evidence of security and identity controls, but narrower than the full set of SOC 2, single sign on (SSO) and role based access control (RBAC). Evidence basis: The homepage states SOC II certified and HIPAA compliant and calls the platform privacy first. No customer access surface (single sign-on, roles or permissions) is documented. Claim Health, claimhealth.com, 2026-10-06. Graded from public evidence only against the Agentic Index 14 point capability taxonomy. No vendor pays for placement.

Does Claim Health give you tracing and observability into agent runs?

Partial under the Agentic Index verification standard. Claim Health publishes some public evidence of logging or observability, but narrower than full tracing and auditability across agent runs. Evidence basis: Platform Intelligence gives real-time visibility into every referral, admission and blocker, in a single view that shows leaders revenue risk, performance and impact across the organization. That view reports status, and no record of what t. Graded from public evidence only against the Agentic Index 14 point capability taxonomy. No vendor pays for placement.

Back to vendors

Claim Health

Q: Who is Claim Health for?

Home health agencies, Hospice providers, Home care and post acute organizations

Also known as: Claim Health AI

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Healthcare agentindependentVerified 2026-09-28

Entry priceCustom (contact sales)Full pricing detail

Claim Health is an AI revenue operations platform for post-acute care (home health, hospice, home care) that works inside the agency's EMR from referral intake and prior authorization through billing, posting and denial follow-up, surfacing only exceptions to staff.

Claim Health builds an AI revenue operations platform for post-acute providers such as home health, hospice and home care agencies.

Coverage Assurance continuously monitors coverage, documentation and eligibility inside the agency's EMR and catches gaps before they interrupt care; Smart Intake gathers referrals from fax, email and portals into one workflow and checks each packet against the agency's clinical criteria; Authorization Autopilot submits prior authorizations and handles renewals; Billing Operations automates payment posting, reconciliation and denial follow-up so staff handle only exceptions; and Platform Intelligence shows the status of every referral and admission in real time.

The platform validates OASIS assessment fields before submission. The vendor states SOC II certification and HIPAA compliance and names agencies including Interim, Excelin, Ascend Health and Home Helpers among its customers. Claim Health, led by CEO Kevin Calcado and a Y Combinator company, announced a $4.4 million seed round led by Maverick Ventures in January 2026.

Vendor details

Canonical URL

https://www.claimhealth.com

Funding status

Claim Health is independent. It raised a $4.4 million seed round (21 January 2026) led by Maverick Ventures with Y Combinator, Peak XV Partners and DHVP. Its CEO is Kevin Calcado.

Company status

independent

Use cases & customers

Primary use cases

Referral intake and eligibilityPrior authorization automationDenial prevention and appealsBilling, payment posting, and reconciliation

Target customers

Home health agenciesHospice providersHome care and post acute organizations

Deployment options

SaaS

Integrations

Claim Health works inside the agency's EMR, though no EMR is named, and centralizes referrals arriving by fax, email and portals; it submits and renews prior authorizations and posts and reconciles payments. No public API is documented.

In practice

A home health agency receives referrals by fax, email and portal and loses some in the shuffle. Smart Intake pulls them into one workflow and checks each packet against the agency's clinical criteria before the referral moves on.

Prior authorizations keep lapsing and delaying starts of care. Authorization Autopilot handles each one from submission to renewal without staff chasing follow ups.

The billing team spends its days posting payments. Billing Operations automates posting, reconciliation and denial follow up and sends only the exceptions to people for review.

Sources & related URLs

Research sources

https://www.claimhealth.com/ https://www.businesswire.com/news/home/20260121240981/en/Claim-Health-Launches-AI-Powered-Revenue-Infrastructure-for-Post-Acute-Care-with-$4.4M-Seed-Funding https://www.ycombinator.com/companies/claim-health

Agentic Index coverage score

6.0 / 14 capabilities · 43%

Integrations & Tool Calling	Full
Claim Health works inside the agency's EMR to monitor coverage, documentation and eligibility, pulls referrals from fax, email and portals into one workflow, submits and renews prior authorizations, and posts payments and reconciles. None of the EMRs it works inside is named. SourceClaim Health, claimhealth.comread 2026-10-06
Workflow Orchestration	Full
Coverage Assurance, Smart Intake, Authorization Autopilot and Billing Operations run the referral to reimbursement cycle for home based care providers as multi-step automated work (intake against criteria, authorization submission through renewal, posting, reconciliation and denial follow-up), with Platform Intelligence across them. SourceClaim Health, claimhealth.comread 2026-10-06
Knowledge Grounding & RAG	Partial
Referral packets are checked against the agency's own clinical criteria and OASIS fields are validated before submission, using the EMR data for each case. No maintained retrieval structure over the customer's knowledge is documented. SourceClaim Health, claimhealth.comread 2026-10-06
Human Oversight & Guardrails	Full
Routine posting, reconciliation and follow-up are automated while exceptions are surfaced to the billing team for review before they are resolved, so teams handle only the exceptions rather than every claim, and intake gaps are surfaced before a referral proceeds. SourceClaim Health, claimhealth.comread 2026-10-06
Security, Identity & Governance	Partial
The homepage states SOC II certified and HIPAA compliant and calls the platform privacy first. No customer access surface (single sign-on, roles or permissions) is documented. SourceClaim Health, claimhealth.comread 2026-10-06
Observability & Auditability	Partial
Platform Intelligence gives real-time visibility into every referral, admission and blocker, in a single view that shows leaders revenue risk, performance and impact across the organization. That view reports status, and no record of what the agents read, wrote or decided per action is documented. SourceClaim Health, claimhealth.comread 2026-10-06
Memory & State Persistence	Not documented
Claim Health describes no memory the agents keep for themselves, what it would hold or how long it would last. Referral, authorization and claim status live in the agency's EMR and billing workflow as its business records. SourceClaim Health, claimhealth.comread 2026-10-06
Deployment & Data Residency	Not documented
Claim Health is a hosted platform that works inside the agency's EMR, and no hosting region or customer environment option is documented. SourceClaim Health, claimhealth.comread 2026-10-06
Prebuilt Agents / Templates / Packs	Partial
Coverage Assurance, Smart Intake, Authorization Autopilot and Billing Operations are modules of one revenue platform sharing one workflow, with Platform Intelligence on top. Whether a module can be bought on its own is not described. SourceClaim Health, claimhealth.comread 2026-10-06
Triggers & Channel Coverage	Full
Work starts on its own when referrals arrive by fax, email or portal, when coverage lapses or documentation gaps appear in the EMR, when authorizations come due for renewal and when claims are denied or payments mismatch, with eligibility rechecked continuously. SourceClaim Health, claimhealth.comread 2026-10-06
Model Flexibility & Routing	Not documented
No model provider or customer model choice is documented. SourceClaim Health, claimhealth.comread 2026-10-06
APIs / SDKs / MCP Extensibility	Not documented
No API, SDK or MCP surface for Claim Health is documented. SourceClaim Health, claimhealth.comread 2026-10-06
Testing, Debugging & Optimization	Not documented
No customer evaluation or testing surface is documented, and denial prediction works on the agency's claims rather than testing the agents. Claim Health reports 80% fewer manual hours, 15% more approved claims and a 3% EBITDA lift for its customers. SourceClaim Health, claimhealth.comread 2026-10-06
Browser / Computer-use	Not documented
No browser or computer control is documented. SourceClaim Health, claimhealth.comread 2026-10-06

The Agentic Index coverage score grades every vendor Full, Partial or Not documented against the same 14 buyer facing capabilities, from public evidence only. Each capability links to how all vendors in the index score on it. How this evidence is graded

Pricing

Custom (contact sales)

Cost watchouts

Revenue cycle tools are often priced as a percent of collections or per claim; the commercial unit was not disclosed this session.

Variable cost rationale

If priced on claim volume or a share of collections, cost scales with the agency claim throughput and recovered revenue, but the unit was not retrieved this session.

Sales call required

Mixed (some tiers require a call)

Key ambiguities

There is no public entry price, and it is not confirmed whether pricing is subscription based or a percent of collections.

Agentic Index verified 2026-09-28

Official pricing page

Related vendors

Alternatives to Claim Health

The closest documented capability profiles to Claim Health among healthcare agents tracked by Agentic Index, ordered by similarity on the same 14 point evidence the rankings use. No vendor pays for placement.

AlethianAI7.0 / 14Fuller documented coverage on Observability & Auditability and Prebuilt Agents, Templates & Packs
Adonis5.5 / 14Fuller documented coverage on Prebuilt Agents, Templates & Packs
Charta Health7.5 / 14Adds documented Testing, Debugging & Optimization
DeepCura7.5 / 14Adds documented Model Flexibility & Routing
Latent Health7.5 / 14Adds documented Browser & Computer Use
Luma Health7.5 / 14Adds documented Model Flexibility & Routing

Similarity is computed from each vendor's Agentic Index coverage score evidence, axis by axis, not from the totals. How this evidence is graded

Compare Claim Health with other vendors →Compare all healthcare agents →See where Claim Health ranks →

Data confidence: medium

Head to head

Claim Health vs Ember Copilot