HIPAA Healthcare Legal Tech Insurance Recovery

A HIPAA-Safe Platform That Replaced the Document Chase and Freed Attorneys to Recover More Claims

We turned a tangle of emails, WhatsApp threads, and scattered PDFs into one secure place where clinics and attorneys finally work from the same page.

A clinic nurse and an attorney standing together in front of the Practice Portal and Attorney Portal dashboards, HIPAA compliant
Project Brief

The claim was worth $10,000. The missing page was worth a week.

Follow one real claim, and the quiet way it stalls - from the bill on day one to the day it sits, earning the firm nothing.

$10,000
The patient's bill
$6,000
The insurer pays part
$4,000
Left for the firm to recover
1 doc
Missing from the file
Days
Lost to email & WhatsApp
$0
Earned while it sits

This is how insurance-recovery work actually runs. Not on legal strategy, but on chasing paperwork.

Our client, a Florida-based law firm specializing in insurance recovery, represents medical practices, hospitals, clinics, and individual doctors when insurers underpay or deny a claim.

For this firm, that work was buried under manual document handling. Clinics sent records over email, WhatsApp, and scattered PDFs. Attorneys read every page by hand to check what was missing, then started the follow-up loop all over again. None of it generated revenue - and moving patient information over email and WhatsApp isn't HIPAA-compliant, where one exposed record can mean thousands in penalties.

The firm came to us with a clear ask: take the grunt work out of claims recovery, and make the whole thing HIPAA-safe. That became our north star.

4 in 10healthcare orgs face 10%+ claim-denial rates
And a large share of those denied claims are never resubmitted at all. The money is there to recover - someone just has to do the work.
The Problem

Why the Old Way Was Quietly Costing the Firm

We started by mapping how a single claim actually moved through the firm. The problems weren't dramatic. They were small, daily, and constant, which is exactly what made them expensive.

Documents Lived Everywhere

CMS 1500 forms, benefit statements, AOBs, and medical records arrived over email, WhatsApp, and shared drives. Finding one document meant searching three.

Attorneys Were Doing Clerical Work

A firm makes money on recovered claims, not on hunting for a missing page. Every hour spent confirming paperwork was an hour not spent on work that pays.

The Follow-Up Loop Never Closed

Someone had to notice a missing file, email the clinic, explain what was needed, and wait. Claims stalled for days on a single back-and-forth.

Patient Data Was Exposed

Sending protected health information over email or WhatsApp simply isn't HIPAA-compliant. With dozens of providers, the firm faced that gap on repeat.

No Record of Who Did What

With everything spread across inboxes and chats, there was no reliable trail of when a document was requested, received, or reviewed.

Recovery Slowed to the Speed of Email

The firm works on contingency. Slower, incomplete claims meant slower payouts, and revenue left sitting on the table.

How We Approached It

We Rebuilt One Workflow Around the People Who Live in It

We didn't set out to build a generic case-management tool. We rebuilt one specific workflow - claim recovery - around the people who live in it every day. Four moves got us there.

Consultant and clinic lead reviewing discovery notes on a whiteboard
01

Listen First

Two early calls to understand how claim recovery actually runs, day to day - not in theory.

Two discovery calls
Real workflow mapped
Pain points captured
Designer sketching a prototype wireframe on a tablet in front of a monitor
02

Prototype the Idea

A high-level prototype to show what a solution could look like - before anyone committed to a full build.

High-level prototype
Solution visualized
Validated before build
Team reviewing a requirements checklist next to a feasibility flowchart
03

Go Deep in Discovery

A detailed requirement doc, an architect-led feasibility review, and a clickable prototype to test.

Requirement document
Architect feasibility review
Clickable prototype
Person standing next to a finished mobile app screen with a confirmation checkmark
04

Build Around It

We rebuilt the claim-recovery workflow around the people who live in it - purpose-built, not generic.

Purpose-built workflow
Designed around users
Not a generic tool
The Build

What We Built: Two Portals and One Source of Truth

Two connected portals put the clinic and the attorney on the same page - instead of across a dozen email threads.

Clinic submits
Drag, drop, done - in seconds
Textract extracts
Fields read, confidence-scored
Gaps flagged
Missing AOB? Caught instantly
Attorney requests
Clinic responds, same screen
Recovery moves
Complete claim, days sooner
The path a single claim now travels - end to end, in one place
Practice Portal
Good afternoon, Dr. Angela Peters 👋
AIIMS Hospital · Friday, July 10, 2026
Last updated: 03:05 PM
24New Claims · $240,500
17Pending Docs · $165,300
28In Progress · $312,800
6Returned · $42,750
Recent ClaimsView all →
PatientInsuranceStatusBilledUpdated
JSJohn SmithDOB 05/12/1980AetnaID: 60054 8793New$8,750.00Jul 10, 202602:58 PM⋯
MGMaria GarciaDOB 11/23/1976Blue CrossID: 90123 4567In Progress$6,250.00Jul 10, 202602:40 PM⋯
DWDavid WalkerDOB 07/08/1965CignaID: 76321 0987New$12,400.00Jul 10, 202601:35 PM⋯
View all claims
PRACTICE

The Practice Portal

Built for clinic staff and doctors who want to be in and out in seconds. Drag and drop a patient's documents, add a name, submit - then track every claim's status, see what's settled and what's owed, and respond the moment an attorney requests something.

Taylor A. SwiftIn Progress
Case Summary
ProviderAIIMS Hospital
CountyMiami-Dade
DOS07/20/2023
Classification
Insurer TypeHMO
WorkflowIDR Process
The Attorney Portal - the control centerWhen a clinic submits a claim it lands here with the heavy lifting already done - fields extracted, gaps flagged, and a one-click way to request whatever's missing.
Claim Detail · OCR Results88% confidence
Patient NameGarcia, Carlos R
Date of Birth08/14/1985
InsuranceAetna (PPO/EPO)
Claim Number—
Date of Service04/19/2024
Total Billed$4,514.04
EXTRACTION CONFIDENCE88%
OCR-Powered ExtractionAmazon Textract reads each document and pulls out what matters - provider, patient, billing lines, CPT codes, amounts. Every field carries a confidence score, so anything messy gets flagged, not trusted blindly.
Documents3/4 uploaded
CMS-1500Uploaded
Benefit StmtUploaded
AOBUploaded
Medical RecordsMissing
Request from clinicSend
Missing-Document Requests, Built InThe system flags what's absent - a missing AOB, say - and the attorney requests it in one click. It lands in the clinic's portal instantly and comes straight back. The week-long chase becomes a same-screen exchange.
Activity log · Claim #1042
Benefit statement uploaded by Platform Admin (admin)
Platform Admin · 07/10/2026 · 3:19 PM
Classification created: DAVIDS / ACA - INDIVIDUAL / Standard Demand
Platform Admin · 07/10/2026 · 3:23 PM
Claim reopened
Platform Admin · 07/10/2026 · 3:28 PM
Claim updated
Platform Admin · 07/10/2026 · 3:33 PM
CMS-1500 document requested
Platform Admin · 07/10/2026 · 3:41 PM
A Real Audit TrailEvery action, request, note, and upload is logged. Nothing slips, and there's finally a clean record of who did what and when.
Admin · users & roles3 roles
JDJohn Doe[email protected]Provider
ASAlice Smith[email protected]Admin
RBRobert Brown[email protected]Attorney
Rate table access Admin role
Billing & reporting Admin role
Claim reassignment Provider role
Full Admin ControlSuper admins manage providers, users, roles, and access. A CMS layer handles insurance companies, plan types, and CPT rate tables by locality - with reporting that ties it together.
Phase Two
Vera
AI assistant · online

Deeper AI automation, next

We're now extending the platform with AI that streamlines the remaining manual steps in the review-and-submit workflow. The OCR foundation laid in phase one is exactly what makes that possible.

Compliance

Built HIPAA-Safe From the Ground Up

For a platform handling this much protected health information, compliance couldn't be a feature bolted on at the end. Every record that used to travel over email or WhatsApp now moves inside a single, controlled environment. The exposure is designed out of the system, not patched over.

Encrypted dataProtected health information secured in transit and at rest.
Role-based accessPeople see only the records they're meant to, and nothing more.
Complete audit loggingEvery touch on a record is tracked, timestamped, and accountable.
No PHI on email or WhatsAppThe informal, non-compliant channels are removed from the workflow entirely.
Projected Impact

What This Is Built to Deliver

5-7 hrs
Reclaimed per attorney, every week
~80%
Fewer manual follow-ups
90-95%
Extraction accuracy on structured forms
0
Patient records left on email or WhatsApp
Hours returned to recovery workThe average attorney loses roughly 12 hours a week to non-billable admin. Document hunting is a real slice of that. Remove it, and those hours go back to the work that earns fees.
Stronger, more complete first submissionsIncomplete documentation is a top reason claims get denied. Catching gaps before submission means more dollars recovered on the first pass.
Confidence-scored extractionAmazon Textract reliably reaches 90-95% on standardized forms like the CMS 1500; scores catch the rest so nothing questionable slips through.
More throughput on contingencyMore complete claims, submitted faster, with less risk. The platform doesn't just save time, it expands how much the firm can recover.

The platform is in active development, so the figures below are projections - grounded in industry benchmarks and the firm's own workflow, not measured results. We'd rather be honest about that than quote numbers we haven't earned yet.

Final Thoughts

A Paperwork Fix That Turned Into Something Bigger

One secure home for every claimClinics and attorneys work from the same record.
The busywork is handledExtraction and follow-ups run on their own.
HIPAA-safe by designNo PHI left on email or WhatsApp.
Hours back on recoveryEvery hour goes to work that earns fees.

This started as a fix for a paperwork problem. It became a single, HIPAA-safe place where clinics and attorneys finally work together, where the busywork is handled, and where every hour an attorney spends goes toward recovery instead of follow-up.

The legal and healthcare worlds are full of workflows like this one. Quietly inefficient. Quietly risky. Costing more than anyone's measuring. At Tech Exactly, that's the work we like best: turning a tangle of inboxes and PDFs into something simple, secure, and genuinely useful.

Let's Talk

Building Something in the Healthcare or AI Space?

Tell us the workflow that's costing you time, and we'll show you what a secure, well-built version looks like.

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