Notes from the build — what we shipped, what we broke, what we learned about AHCIP billing along the way.
Most AHCIP billing software falls into one of two categories: a managed submission service (Dr. Bill, Petal), or an EMR billing module (TELUS PS Suite, OSCAR Pro, Accuro). Neither of them reads the clinical note against the AHCIP fee schedule. We built one that does.
v12 of the Zorva prompt ships with 18 AHCIP rules covering the highest-yield patterns Alberta billers see on every claim. This post walks through every one — the rule, the AHCIP denial code it catches, and the one-line fix the biller sees.
Per-claim pricing punishes the clinics that need the most help. The clinics with the highest denial rates pay the most for a tool that should be making their lives easier. We picked flat-fee because the alternative rewards us for not running the auditor on the trickiest claims.
Filed under pricing
Zorva started as an Ontario-pivot idea. Then we looked at the Alberta AHCIP fee schedule, talked to six Alberta billers, and realized the entire competitive landscape was different. The opportunity was bigger.
Filed under go-to-market