For Technology Partners

Bill review infrastructure.
In your product.

Embed workers' compensation medical bill repricing, automated adjudication, and payment integrity directly into your platform through a single API. No bill review engine to build, no reimbursement rules to maintain. Your product, your workflow, your customer experience stay.

RuleTrace™ provides the pricing logic and regulatory source behind every decision.

View Developer Guide →
Launch in weeks • No regulatory maintenance • Sub-second responses • Built-in documentation

The Problem

Building bill review internally is harder than it looks

Adding workers' compensation bill review capability requires much more than a pricing calculation. Platforms must manage jurisdictional fee schedules, reimbursement logic, regulatory updates, and documentation requirements that change over time.

Even teams that have built bill review before tend to find the ongoing maintenance is the bigger cost, not the initial build.

Integrate once. We handle the rules, the regulations, and the ongoing maintenance.

Embed RuleTrace™ directly into your product

Show exactly how pricing decisions were made, inside your UI, not a separate system.

What your users see:

  • Fully white-labeled to match your product
  • Line-by-line pricing with rule logic
  • Built for internal workflows and adjusters

What RuleTrace™ actually shows:

  • Fee schedule logic used
  • Step-by-step calculation breakdown
  • Rule citations and regulatory references
  • Clear explanations for every pricing decision

Everything needed to validate, defend, or dispute the outcome without digging through systems.

Delivered via API, with no separate system:

  • Render directly from API response (JSON)
  • Or embed via secure iframe
  • No additional login required
View Live Embedded Example →

Example: Embedded inside a claims platform

RuleTrace™ embedded inside a claims management platform

Rendered via API response or secure iframe and no separate login required

Where BillSentry fits into your platform

BillSentry provides embedded bill review and payment integrity infrastructure for:

✓ Claims administration platforms
✓ Bill review systems
✓ Clearinghouses
✓ Medical cost containment platforms
✓ TPA software
✓ Provider audit solutions

Typical integration flow

1

Your platform submits bill data

→
2

BillSentry reprices and adjudicates the bill

→
3

Your platform receives allowances + reason codes + RuleTrace™

→
4

Your workflow continues unchanged

JSON in. Defensible reimbursement out.

BillSentry serves as the infrastructure behind your platform. Not a separate system your users must access.

→ Use BillSentry for all bills or only where you need it.

Integrate BillSentry your way

Use BillSentry alongside your existing logic, or expand coverage instantly, without rebuilding your platform.

1

Expand state coverage instantly

Already support a few states? Cover the rest without rebuilding what already works.

  • Keep your existing pricing logic for CA, NY, etc.
  • Use BillSentry for all other jurisdictions
  • Gradually transition over time. Or don't.

No rewrite required

2

Fill gaps in complex billing scenarios

Handle edge cases without building more logic.

  • Out-of-state bills
  • Facility vs professional edge cases
  • Rare or changing fee schedules

Use BillSentry only where your system falls short

3

Full pricing engine replacement (when ready)

Replace internal pricing logic with a single API.

  • Submit bill → get pricing + RuleTrace
  • Eliminate rule maintenance entirely
  • Reduce engineering + compliance overhead

Move from partial → full adoption on your timeline

4

Embed RuleTrace™ directly into your product

Show your users the math.

  • Display RuleTrace inside your UI
  • Share via link or QR code
  • White-label to match your product
See the embedded example →

Add pricing transparency without building it yourself

BillSentry is not all-or-nothing.
Start with one state, one workflow, or one use case. Expand as needed.

Workers' Compensation Payment Integrity Through API

Everything your platform needs to review, reprice and adjudicate medical bills without maintaining the underlying reimbursement engine.

Pricing & Adjudication

  • ✓ Medical bill repricing
  • ✓ Professional + facility adjudication
  • ✓ Fee schedule and reimbursement logic
  • ✓ Coding and reimbursement validation
  • ✓ State-specific pricing rules
  • ✓ Real-time API responses

Payment Integrity & Documentation

  • ✓ Pre-payment integrity
  • ✓ Line-level allowances and reason codes
  • ✓ RuleTrace™ pricing documentation
  • ✓ Regulatory citations and source links
  • ✓ Defensible reimbursement decisions
  • ✓ Embedded or white-labeled RuleTrace™

BillSentry maintains workers' compensation pricing and reimbursement logic across all 50 states plus OWCP as part of the platform.

Learn more about Workers' Compensation Payment Integrity →

Payment Integrity Infrastructure, Not Another Platform

Your customers don't need to know BillSentry is there.

BillSentry operates as the reimbursement intelligence behind your existing product. Your platform continues to manage the user experience, claims workflow and customer relationship while BillSentry handles workers' compensation pricing, adjudication, and regulatory logic. Use BillSentry for a single state, a difficult billing scenario, or every medical bill you process.

Embed

Use the BillSentry API behind your existing workflow.

White Label

Keep your branding and customer experience.

Scale

Expand from one jurisdiction to all 50 states plus OWCP without rebuilding your pricing engine.

Build vs. Partner

Building internally

  • ✕ Significant engineering investment
  • ✕ Ongoing rule maintenance
  • ✕ Regulatory tracking responsibility
  • ✕ Documentation tooling required
  • ✕ Long time to market

Using BillSentry

  • ✓ Weeks to integrate, not years
  • ✓ Fee schedules, reimbursement rules and regulatory updates maintained for you
  • ✓ Regulatory changes handled before they hit your code
  • ✓ RuleTrace documentation built in
  • ✓ Your engineers stay focused on your core product

BillSentry allows your team to focus on your core product while we handle bill review infrastructure.

Getting started with BillSentry

Our typical onboarding process includes:

1

Technical integration discussion

Walk through your architecture together before any code gets written.

2

Sandbox provisioning

Full sandbox, real fee schedule data, no production traffic required.

3

Integration testing

Validate results, test edge cases, and confirm your integration behaves as expected end-to-end.

4

Production rollout

Go live with direct support from the BillSentry engineering team throughout the process.

Our engineering team works directly with partners during integration to ensure a smooth implementation.

Plan your integration with our engineering team

If you are evaluating how to add bill review capability to your platform, we are happy to review your architecture and discuss integration options.