Clarabill
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Audit medical bills with precision.
Protect patients from overcharging.

Clara reconciles provider bills against insurance EOBs, line by line—surfacing balance billing, duplicate charges, and other documented discrepancies, with citations your advocate or attorney can act on.

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100%

Line-item auditable

Isolated

Patient binders

Cited

Every finding, sourced

Advocate-led

You keep final judgment

Interactive artifact

See what Clara delivers

Click below to see an illustrative audit report — built from example numbers, not a real encounter — showing the reconciliation format and line-item citations advocates receive.

Illustrative example
ENCOUNTER ID: #ENC-8921-SF (example)

Audit breakdown & financial summary

Total billed$14,850.00
Allowed amount$8,200.00
Patient responsibility (EOB)$1,150.00
Discrepancy (patient $)$2,450.00
Line item analysisAudit status
Patient billed $3,600.00 vs. $1,150.00 EOB responsibilityProvider statement exceeds the patient share set by the insurer.
Balance billing
CPT 74177 - CT abdomen/pelvis w/ contrast, billed twiceSame date and time of service; only one instance was adjudicated by the insurer.
Duplicate billing
+ 1 more finding in full report
Click to view full interactive modal & reconciliation trace →

Advocate-first operations

Designed for your daily workflow

Built to eliminate administrative friction so patient advocates and directors can focus on high-touch care.

⏱️

Hours of manual work saved

Automate tedious line-item cross-referencing between lengthy EOBs and hospital bills so staff can focus on high-touch patient advocacy.

📱

Mobile handoff document scanning

Snap photos of paper medical statements or multi-page bills on a phone and seamlessly hand them off to the desktop web app in real time.

📁

Isolated electronic patient binders

Keep every client's bills, EOBs, and audit trails organized in isolated digital binders with strict database rules and no cross-contamination.

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Secure, auditable record-keeping

Every encounter, EOB, and line-item match rationale is archived in an isolated digital binder with a full audit trail your team can revisit anytime. Retention follows your policies and applicable state law.

Built-in logic engine

What Clara checks

Every check is either deterministic—provable from your documents—or flagged for professional review. We don't blur the two.

Deterministic checksAssertable from the documents alone

RULE: PRICE MISMATCH

Balance billing & math mismatches

Detects when a provider bills the patient above the responsibility stated on the insurance EOB for the same adjudicated charges.

Needs: bill + EOB.
RULE: DUPLICATE BILLING

Duplicate line items

Flags the same CPT/HCPCS code, same date, same time of service, billed more than once on an itemized statement.

Needs: itemized bill. A plain balance-due summary has no codes to compare.
RULE: UNIT COUNT

Implausible unit counts

Flags units billed against a CPT/HCPCS code that exceed the CMS Medically Unlikely Edit (MUE) threshold published for that code.

Needs: itemized bill, for the same reason.
RULE: DATE RANGE

Charges outside the admission window

Flags line items dated before admission or after discharge, for inpatient encounters billed on a UB-04 with a stated admission/discharge window.

Needs: itemized inpatient bill (UB-04). Doesn't apply to outpatient CMS-1500 claims, which don't carry an admission window.
RULE: UNMATCHED LINE

Unadjudicated bill lines

Flags charges present on an itemized bill with no corresponding line on the insurance EOB.

Needs: itemized bill + EOB.
RULE: STALE BALANCE

Insurer payments missing from the bill

Flags cases where the EOB shows the insurer already paid, but a reissued or updated bill doesn't reflect that payment in the balance due.

Needs: bill + EOB.

Flagged for advocate reviewRequires professional judgment or additional records

REVIEW: NO SURPRISES ACT

No Surprises Act exposure

May warrant review because emergency services, air ambulance transport, and certain out-of-network ancillary providers (anesthesiology, pathology, radiology, assistant surgeons, hospitalists) at in-network facilities are protected from balance billing — signed consent is legally void for these categories. Our highest-dollar lever when it applies.

Needs: bill + EOB, plus the patient's account of the visit. EOB formats vary by insurer and don't reliably label network status, so this always needs advocate or attorney confirmation, not just document review.
REVIEW: CHARITY CARE

501(r) charity care eligibility

May warrant review because nonprofit hospitals cannot charge financial-assistance-eligible patients more than Amounts Generally Billed under IRC 501(r). Can reduce a bill substantially with no billing error required.

Needs: the hospital's financial assistance policy plus patient income information — neither comes from the bill or EOB.
REVIEW: FACILITY FEE

Outpatient facility fees

May warrant review because off-campus provider-based billing is only permitted at certain grandfathered or excepted sites — a determination Clara cannot make from patient documents alone.

Needs: bill (HCPCS G0463) plus the site's excepted-status disclosure, which isn't a patient document.
REVIEW: PREVENTIVE CARE

Preventive care cost-sharing

May warrant review when a plan applies coinsurance or deductible to a scheduled preventive screening instead of the ACA-mandated $0 patient cost — this is the version with real dollar exposure, since it can shift the full allowed amount onto the patient rather than a small copay. A non-zero copay is the smaller, more visible version of the same error. Diagnosis codes and coverage terms can create legitimate exceptions (e.g. a screening colonoscopy that finds a polyp).

Needs: itemized bill or superbill (for diagnosis codes) plus the plan's coverage terms (SBC/EOC).
REVIEW: COORDINATION OF BENEFITS

Coordination of benefits gaps

May warrant review after an accident, when a charge appears unpaid or billed to the patient despite two payers being available — health insurance and auto PIP/MedPay. A gap usually means the wrong payer was billed first, or the two were never coordinated.

Needs: two EOBs (health insurance + auto PIP/MedPay). Confirming which payer should have been primary is a policy- and state-specific determination.
Relevant to: PI / lien resolution
REVIEW: FEE SCHEDULE CAP

Charges above the workers' comp fee schedule

May warrant review because nearly every state caps what a provider can charge under workers' compensation, and prohibits balance billing above that cap.

Needs: itemized bill + the state's workers' comp fee schedule — not a patient document.
Relevant to: PI / lien resolution
REVIEW: UNBUNDLING

Unbundling & NCCI edits

May warrant review if CPT codes appear to violate NCCI bundling rules. Requires an itemized UB-04 or CMS-1500 — patient-facing summary statements usually omit the modifiers needed to check this.

Needs: itemized bill (UB-04 or CMS-1500).
REVIEW: TIMELY FILING

Timely filing

May warrant review if a claim was filed past the insurer deadline. Requires the claim submission date, which does not appear on patient-facing documents.

Needs: claim data from the insurer.

What Clara does: deterministic reconciliation between the documents you provide, plus flags for professional review.

What Clara doesn't do: make coding determinations, assert fraud, or replace advocate or attorney judgment.

Who Clara serves

Built for how you work

The same reconciliation engine, applied to three different workflows.

Patient advocates

Scan a client's unsorted bills and EOBs into one organized binder, then run them through Clara's patient-context intake — it reconciles line items automatically and flags what needs review. Work from the findings to decide what's worth pursuing, then use the audit report to correct what's owed.

Medical debt defense attorneys

Verify that the amount claimed in a collections suit is actually owed before you respond or negotiate. A wrong amount is often grounds for an FDCPA counterclaim — misrepresenting a debt's amount is a violation, and the Act's fee-shifting is what makes small-dollar defense cases worth taking.

Personal injury / lien resolution

Audit the provider bills underlying a hospital lien before negotiating a reduction — including whether auto PIP/MedPay and health insurance were coordinated correctly, and whether workers' comp charges stayed within the state fee schedule.

Our mission

Why I built Clara

After my son was born, I spent weeks cross-referencing his hospital bills against the insurance EOBs, trying to figure out which charges were even real. I'm a software engineer, not a healthcare professional—the bills confused me.

Patient advocates do that same line-by-line reconciliation by hand, for every client, every day. I built Clara to automate that first pass, so advocates can spend less time on spreadsheets and more time on the parts of the job that actually need a person.

Frequently Asked Questions

Everything You Need to Know

Common questions about Clara's audit engine, data privacy, and workflow integration.

Q:How does Clara handle patient data privacy and HIPAA compliance?

A:Clara is built on enterprise Google Cloud Vertex AI infrastructure operating under a signed Business Associate Agreement (BAA). Patient data is encrypted in transit (TLS 1.3) and at rest (AES-256) and is never used to train public AI models.

Q:How long are patient records and audit histories retained?

A:HIPAA's 6-year rule governs compliance documentation, not patient record retention — that's set by state law and varies by jurisdiction. Encounter files and line-item decision trails are archived in isolated electronic binders for as long as your engagement and applicable law require, and you control deletion.

Q:How does mobile-to-desktop document handoff work?

A:You can scan paper hospital bills or physical EOBs using your smartphone camera. The upload automatically syncs to your desktop workspace instantly—no manual downloading or email attachments needed.

Q:Does Clara replace the advocate's or attorney's judgment?

A:No, and it's not designed to. Clara performs deterministic math and citation checks against the documents you give it, and separately flags items that need professional judgment — coding disputes, medical necessity, legal exceptions. It never asserts fraud or a coding violation on its own; every finding cites the exact line and source document so you can verify it before acting.

Q:What documents does Clara need?

A:A bill and the matching insurance EOB cover balance billing and math mismatches — that's the only deterministic check that works off a plain balance-due statement. Everything else that reads as deterministic (duplicates, unit counts, unmatched lines, the date-range check) needs a true itemized bill (UB-04 or CMS-1500) with CPT/HCPCS codes, because there's nothing to compare on a summary statement. Many patients only receive a summary and have to specifically request the itemized version from the provider — each check on the page states exactly which documents it needs.

Q:What can't Clara determine?

A:Clara can't make a coding determination, assert fraud, or confirm medical necessity — those require clinical judgment and often documentation Clara doesn't have. It also can't verify facility exception status, insurer claim-filing dates, or diagnosis-code context unless that data is provided. Those cases are flagged for advocate or attorney review, not resolved automatically.

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Connect with the Clara team

Have a question or want to review an example audit? Reach out directly.