Pre submission claim integrity

Stop the denial before it is filed.

MergeAct is the pre submission integrity layer for hospital revenue cycles. Before a claim reaches SEHA, Medicare, or a commercial payer, it runs the checks that stop a denial from being filed at all. A denial caught before submission never enters the rework pipeline.

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Built around the engine used in a live hospital deployment Nothing retained · BAA before production
The denial that costs twice

A CLAI 008 overlap denial is paid for twice — once to file it, once to fix it.

When two encounters overlap on the calendar, the payer bounces the claim. SEHA, Medicare, and most commercial payers reject every overlapping submission. The collision was visible inside the extract before the file ever left the building, but nobody was looking for it at that moment. So the claim ships, the denial returns weeks later, and the work begins again.

CLAI 008
Overlap rejection
The denial a payer issues when two encounters share a date. It is mechanical, predictable, and entirely catchable before the claim is filed.
Weeks
Until the denial returns
By the time the rejection comes back, the claim has aged. A biller now reopens it, finds the overlap, corrects, and resubmits.
0
Rework on a caught overlap
A denial caught before submission never enters the rework queue. The cleanest claim in the system is the denial that is never filed.
Three checks, run before the payer sees the file

What MergeAct checks before a claim leaves the building.

Each check runs against the extract before submission. Each one removes a denial that would otherwise be filed, returned, and reworked. MergeAct does not change how your billers work — it sits underneath that work and resolves the collisions before the file goes out.

Check 01
Encounter Overlap Audit
Compares the dates of every encounter in the extract and flags any pair that overlaps on the calendar. This is the collision that triggers a CLAI 008 denial. MergeAct surfaces it while it can still be corrected, before the payer ever receives the claim.
CatchesCLAI 008 collisions
Check 02
HCPCS Reconciliation
Reads the HCPCS lines on the claim and classifies every movement request into a clear verdict — proceed or hold. A line that would not survive a payer rule is held before it ships, so the claim that goes out carries only what will be paid.
Returnsproceed or hold
Check 03
Activity Time Reconciler
Finds duplicate timestamps inside an extract and resolves them before the file reaches the payer. Two activities recorded against the same minute read as a single event to a payer system. MergeAct separates them so the claim reflects what actually happened.
Resolvesduplicate timestamps
The differentiator

The engine that already runs on a hospital floor.

MergeAct is an early-access product being built around NOMOI Relay's detection engine. It is not available to purchase today. The underlying engine already runs in Relay's hospital deployment, so the product does not begin as a clean-room rewrite.

Proven in live use. Sharper with every correction.

The detection engine behind MergeAct is in active use inside a working hospital revenue cycle. Each correction it sees on the floor — every overlap a biller confirms, every edge case a payer rule exposes — feeds back into the engine. That operating evidence informs the MergeAct product now being prepared for early access.

  • Same detection engine as Relay's live hospital deployment, not a parallel build.
  • Proven against real claims, real payers, and real denial patterns.
  • Every correction on the hospital floor sharpens the engine for every instance.
  • A denial caught before it is filed never enters the rework pipeline.
What changes, what does not

Your billers keep their workflow. The overlap does not reach the payer.

MergeAct does not replace your billing team and does not ask them to learn a new system end to end. It runs before submission, underneath the work they already do, and removes the denials that the calendar would otherwise create on its own.

Stays the same
  • The billing team. No headcount change, no end to end system migration.
  • Your clearinghouse and your payer contracts. MergeAct runs before submission.
  • The extract format your billers already produce and review.
  • The discharge process on the clinical floor. Nothing changes for the clinician.
Stops happening
  • CLAI 008 overlap denials entering the rework queue weeks after the fact.
  • HCPCS lines that ship and then bounce against a payer rule.
  • Duplicate timestamps that read as a single event to a payer system.
  • A biller reopening an aged claim to fix a collision that was visible all along.
Built for protected health information

Where the data goes is the first decision, not the last.

Hospital claim data is protected health information. MergeAct treats that as an architecture constraint, not a checkbox. Its planned production posture is separate tenancy per hospital, no claim retention, no model training on claim data, and a BAA before any production use. Early access and pricing have not opened.

Nothing retained
MergeAct runs every pre submission check, returns the verdict, and retains nothing once the claim clears. The extract is processed in the moment and is not stored afterward.
No model training
No claim data, no extract, and no patient record trains any AI model. The engine sharpens on confirmed corrections, never on raw protected health information.
BAA before production
A Business Associate Agreement will be executed before the first production claim is processed. Any pre-production evaluation will use synthetic and de-identified data until that paperwork is in place.
Questions revenue cycle directors ask

Common questions, plain answers.

What is a CLAI 008 denial?
CLAI 008 is the rejection a payer issues when two encounters overlap on the calendar. SEHA, Medicare, and most commercial payers bounce every overlapping claim. By the time the denial returns, the claim has aged and entered the rework pipeline. MergeAct compares encounter dates before submission and flags the overlap while it can still be corrected.
How is MergeAct different from a denial management tool?
A denial management tool works after the denial has been filed and returned. MergeAct works before submission. It runs the Encounter Overlap Audit, HCPCS Reconciliation, and the Activity Time Reconciler against the extract so the collision is resolved before the payer ever receives the file. A denial caught before submission never enters the rework pipeline at all.
What does the HCPCS reconciliation actually return?
It reads the HCPCS lines on the claim and classifies every movement request into a clear verdict — proceed or hold. A line that would not survive a payer rule is held before it ships. The claim that goes out carries only what will be paid, so there is nothing for the payer to bounce.
Is this the same engine as the hospital deployment?
MergeAct is being built around the same detection engine used by NOMOI Relay's hospital deployment. The engine has operating evidence against real claims and payer rules; MergeAct itself is still preparing for early access and is not currently offered for sale.
Is our claim data safe?
The planned production posture keeps each hospital in a separate tenant, retains nothing once a claim clears, and trains no model on claim data. A Business Associate Agreement will be executed before the first production claim is processed. Any earlier evaluation will use synthetic and de-identified data.
Can I buy MergeAct today?
No. MergeAct is not currently offered for sale. Early access has not opened and pricing is TBA. Leave one email below if you want to know when that changes.

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