Structured around the operational complexity of surgical and high-acuity specialty claims.
Human-reviewed AI for specialty revenue cycle management
Revenue cycle management, simplified for specialty care.
Citron Health combines expert RCM operations with payer intelligence, human-reviewed AI, and workflow automation to help specialty providers reduce preventable denials, prioritize work, and collect with more confidence.
Built for specialty workflows
Human-reviewed AI
Payer intelligence
Compliance-aware workflows
Recommendations are assistive, inspectable, and designed for operator approval.
Resolved outcomes strengthen future prioritization, evidence choice, and playbooks.
Evidence, controls, approval checkpoints, and auditability stay inside the workflow.
The problem
Specialty RCM breaks down when the work is split across disconnected systems.
Payer rules, prior authorization, documentation, coding, denials, A/R, and underpayments are usually managed in separate tools and inboxes. Citron brings them back into one claim lifecycle with evidence-backed recommendations and clear human checkpoints.
Critical policy, authorization, and adjudication patterns stay fragmented across portals, remits, and local operator memory.
Teams see aging lists instead of prioritized claims with evidence, financial exposure, and clear next-best actions.
Authorization variance, documentation drift, and coding mismatches are often discovered only after the payer responds.
Operators need recommendations they can inspect, approve, and audit instead of opaque automation claims.
Platform
One operating system for the claim lifecycle.
Citron connects the revenue cycle spine, payer intelligence, operator guidance, and workflow controls so teams can act on the next important claim with more confidence.
Citron keeps eligibility, authorization, documentation, coding, claims, denials, A/R, payments, and outcome learning connected as one claim lifecycle.
UI fragmentEligibility -> Authorization -> Documentation -> Coding -> Claim
Payer behavior becomes operational memory: what evidence works, where denials repeat, and which steps reduce risk before the next claim is touched.
UI fragmentPayer insight: auth revisions and operative note alignment reduce repeat denials.
Human-reviewed AI drafts next actions for coding review, prior-auth outreach, appeals, A/R follow-up, and underpayment review with visible reasoning.
UI fragmentDraft next action with cited evidence and required reviewer.
Evidence-backed recommendations, compliance-aware workflows, approval checkpoints, and auditability stay embedded in the workbench.
UI fragmentEvidence bundle attached · human review required · audit trace active
Operating loop
Prevent avoidable errors. Recover what still fails. Learn from every payer outcome.
Catch payer-rule misses, auth variance, documentation gaps, and coding drift before the claim leaves the lifecycle spine.
Prioritize denials, A/R work, and underpayments with evidence-backed recommendations and human checkpoints.
Turn resolved claims into payer memory, better specialty playbooks, and lower future claim risk.
Working proof of concept
A focused proof of concept follows a specialty claim from intake to payment.
A working proof of concept follows a specialty claim from intake to payment, showing how payer intelligence, workflow optimization, human-reviewed AI, and compliance controls work together.
What you will see
One claim lifecycle, one payer intelligence moment, one copilot recommendation, one human review checkpoint, and one outcome learning loop.
Control and evidence layer
Recommendations stay credible because operators can inspect the evidence and approve the action.
Citron is designed for compliance-aware workflows, with evidence bundles, review checkpoints, auditability, and outcome capture built directly into the operating flow.
Source documents, authorization history, claim events, and remit context travel with every recommendation.
Operators stay in control of outbound decisions, edits, approvals, and escalations.
Unsafe automation paths stay blocked until the evidence state and workflow controls are clean.
Resolved work updates payer intelligence and future prioritization instead of disappearing into side notes.
Operator console
Operator workbench
Elegant operator workbench for denials, A/R, coding, evidence, and payer trends.
What operators do
- Prioritize denials and A/R
- Review coding and authorization risk
- Inspect evidence before action
- Approve AI-drafted next actions
- Monitor data quality and payer trends
Control posture
Every recommendation carries evidence, controls, and a named human checkpoint. Data quality and payer trend visibility stay in the same workbench.
Priority routing
Evidence attached
Manager oversight
Console preview
Open the operator console when you want the working surface, not the company story.
The console is the operator cockpit for claim work: denials, authorizations, coding review, evidence inspection, queue prioritization, payer intelligence, and data quality monitoring.