The surprise bill
Bills the law says they don't owe
Out-of-network charges for care at an in-network hospital, checked against the No Surprises Act and stopped.
For self-insured employers, coalitions & portfolios
Your health plan, independently checked.
If you self-insure, you're running a health plan. CuraClaims reads every claim your plan pays, from both sides, against your contracts, your plan document and the law, and hands you a signed answer: what you paid, what you should have paid, and what you can get back.
No carrier change
No IT project
Nothing asked of employees
First screening free
The realization
The negotiated dollar and the paid dollar are rarely the same dollar.
You negotiate rates, discounts and plan terms carefully. Then claims are priced and paid one at a time, by someone else, and almost none are ever checked independently. That's where the money goes.
Act 01 — The stakes
You pay every claim. Almost no one checks them.
01 What one percent is worth
Every point your plan pays wrong is real money.
5,000
$15,000
Simple arithmetic on your inputs, not an estimate of your plan. Your free screening gives you the real number.
Your plan pays in claims each year$75M
Every 1% paid wrong$750K
Every 1%, over a three-year contract$2.25M
Rising fast
Benefit costs per employee are climbing faster than wages※employer benefit-cost surveys · 2026 projections. Every point lands on your margin and your employees' paychecks.
Rarely checked
Audits review a sample every few years. Carriers review their own work. Errors run for years unseen.
Your duty
As plan sponsor you answer for what the plan pays, and employees have begun to sue※CAA 2021 · ERISA fiduciary suits, 2024–25 over it.
Act 02 — How we're different
The carrier can't grade its own homework.
02 A sample versus every claim
Independent. Every claim. Both sides. Signed.
A typical audit pulls a few hundred claims every few years. We read all of them, every week, and we look both ways: where the plan overpaid, and where it shortchanged a provider or an employee.
A typical claim audit
A sample, every few years
ReviewedNever looked at
CuraClaims
Every claim, every week
Read & clearedPlan overpaidProvider or employee shortchanged
| Your carrier's own review | Periodic audit firm | Contingency recovery vendor | CuraClaims | |
|---|---|---|---|---|
| Independent of the carrier | No | Yes | Yes | Yes |
| Coverage | Its own work | A sample, every 2–3 years | High-dollar claims | Every claim, every week |
| Protects employees too | No | No | No | Yes, both sides argued |
| Finding independent of the fee | No | Yes | No, paid a share | Always |
| What you get | Internal adjustments | A findings report | Recovered dollars | A signed, cited determination |
Illustrations are not to scale. Comparisons are typical of each category; individual providers vary.
Act 03 — What you see
Every claim, every line, both directions.
03 Your plan, read in full
Overpaid, underpaid or wrongly denied. You see all three.
One view of your whole plan: what was paid, what the contract supports, where it went wrong, and who it affected. Every finding is cited to its source and signed by a person.
curaclaims · plan audit · sample employer plan
SAMPLE DATA
Plan audit · rolling 12 months
Sample Manufacturing Co. Health Plan
Claims read
186,420
100% of paid claims
Plan paid
$58.2M
4,812 employees
Paid above contract
$1.31M
recoverable, cited
Employees protected
212
bills & denials fixed
Where the plan paid wrong
Latest findings
Knee arthroscopy · discount not appliedSIGNEDOverpaid $2,360 · network fee schedule cited
Same-day MRI billed twiceRECOVERY FILEDOverpaid $1,140 · duplicate line
ER visit denied as non-emergencyEMPLOYEE PROTECTEDPlan document §4.2 · sent back for reprocessing
Out-of-network anesthesia, in-network hospitalEMPLOYEE PROTECTEDNo Surprises Act · member billed in error
Plan paid$6,480
Contract supports$4,120
Knee arthroscopy · overpaid $2,360
- Contract rate: Schedule Acited
- Discount: not appliedfound
- Plan document: citedsigned
SAMPLE · SYNTHETIC. A person signs every determination.
Contract pricing
Rates, discounts and fee schedules, applied the way you negotiated them.
Duplicates
The same service paid twice, or paid when another payer was responsible.
Plan rules
Exclusions, limits and eligibility, checked against the plan you designed.
Coding & necessity
Upcoding, unbundling and care that doesn't match the clinical record.
Out of network
Surprise-billing rules applied, disputes triaged, arbitration files prepared.
Your employees
Wrongful denials and incorrect member bills, found and fixed.
Act 04 — Your people
The plan is a promise. We check that it's kept.
04 For the people the plan is for
When the plan overpays, your employees often overpay too.
Their deductible and coinsurance are a share of the same price. When a claim is priced wrong, they pay wrong. When it's corrected, their share comes down with it.
The denied visit
The coverage you designed
Denials that don't match your plan document are found and sent back for reprocessing, so families get what the plan promised.
The overcharged share
Savings in their paycheck too
When a claim is repriced to the contract, the employee's share is repriced with it. The savings reach them, not just the plan.
Benefits are a promise to your people.
- No new app
- No new card
- No calls from us
- Nothing asked of employees
Act 05 — How it works
No carrier changes. No IT project. About three hours of your team's time.
05 From screening to every claim, every week
Start with one quarter of claims. See your own numbers in two weeks.
Step 1 · no cost
Screening
One quarter · ~2 weeksWhat the plan likely overpaid, where employees were wrongly billed, and the patterns behind both.
Step 2
Baseline Read
24-month look-backEvery claim read. Every finding cited and signed, with recovery files and a record of independent oversight.
Step 3
Plan Audit
Every claim · every weekErrors caught in weeks, not years, with a quarterly report for your benefits committee.
Step 4 · optional
Claim Assurance
Troubled claimsDenials, disputes and surprise-billing cases taken over and run to resolution.
Your plan has a legal right to its own claims data. We work under a Business Associate Agreement and draft the data request to your administrator for you.
06 The same engine, already at work
Built for sensitive data: FedRAMP High Ready, agency authorization in process. HIPAA and a BAA from day one.
Already reading claims for a top-5 payer, a 46-hospital system and a federal pilot.
About a third of the waste it finds runs the other way, as underpayment. That's why both sides accept the answer, and why your administrator can act on it.
80M+
Claims analyzed
production engagements
$380M
Structural waste surfaced
a third ran the other way
28
Patterns no rulebook contained
top-5 U.S. integrated payer
72%
Appeal success rate
vs. 38% industry avg.
Act 07 — At scale
One agreement. Every company in the portfolio.
Portfolio view SAMPLE
Company A · manufacturing
$1.31M
Company B · logistics
$930K
Company C · software
$480K
Company D · retail
$760K
4 of 4 plans read · signed$3.48M
07 For portfolios, coalitions & purchasing groups
You negotiate the terms. We prove they're honored.
Investment portfolios, benefits coalitions and brokers win better contracts for the companies they serve. CuraClaims makes those savings measurable, plan by plan and claim by claim.
- One master agreementStandard terms for every member company.
- Companies opt inA one-page addendum. No new negotiation or procurement cycle.
- A free screening for eachEvery plan sees its own number first.
- One portfolio reportVerified results across every plan, ready for the board and the next renewal.
08 The terms
Priced your way.
The finding never varies.
The first step is free. After that, pay a fixed fee, per employee, per claim or on results, alone or blended. Whatever you choose, the answer is the same.
01 · free to start
See it before you buy it
The screening costs nothing. You decide what comes next with your own numbers in hand.
02 · your structure
Priced the way you budget
Fixed fee, per employee per month, per claim or on results. Blend them to match how your plan is funded.
03 · one answer
The finding is locked first
Every determination is completed, signed and locked before any fee applies, so the answer never bends toward the bill.
09 Questions employers ask
Do we have to change carriers or administrators?
No. CuraClaims works alongside your current carrier, third-party administrator and pharmacy benefit manager. Nothing about how claims are processed changes.
Will our employees notice anything?
Only the good part. Nothing is asked of employees. When we find a member who was wrongly denied or billed, we flag it so it can be fixed.
Can we share our claims data with you?
Yes. Your plan has a right to its own claims data, and the Consolidated Appropriations Act of 2021 prohibits gag clauses that restrict it. We work under a Business Associate Agreement and draft the data request to your administrator for you.
How is this different from the audit our carrier or consultant already does?
Typical audits review a sample of claims every few years, and carriers review their own work. CuraClaims reads every claim, every week, independently, from both sides, and delivers a signed, cited determination. Our finding never varies with our fee.
We manage benefits across many companies. How does this work for a portfolio or coalition?
One master agreement covers every member company. Each company opts in with a one-page addendum, gets its own free screening, and the portfolio gets one report showing verified results across every plan.
What does it cost to start?
Nothing. The first step is a screening of one quarter of claims, delivered in about two weeks at no cost.
See your own numbers
A free screening of one quarter of your claims.
One introduction to your benefits lead is all it takes. In about two weeks, you'll see what your plan overpaid and where your employees were wrongly billed.