What is Cendri Health?

Cendri Health is the reconciliation layer between clinical documentation and revenue cycle for behavioral health and SUD facilities. It adds payer outcome intelligence, clinical-to-RCM reconciliation, AI prior-authorization letters and denial appeals, ambient Scribe, a 4-model risk engine, and a clinical co-pilot on top of your existing EHR — live API integrations with Kipu and Sunwave today, additional EHRs built per facility — without replacing it.

How does Cendri's prior authorization AI work?

Cendri uses 24,276 claims baselined across two pilot facilities, 8 major payer templates, and 5 ASAM levels of care to draft payer-specific authorization letters calibrated to your facility's approval history. Every approval, denial, and appeal feeds back into the engine through a patent-pending closed-loop outcome learning system.

Does Cendri replace my EHR?

No. Cendri is the reconciliation layer — not an EHR replacement. It runs live API integrations with Kipu and Sunwave today, with additional EHRs built per facility. Onboarding is a configuration exercise, not a development project.

Is Cendri HIPAA compliant?

Cendri is HIPAA-aligned on AWS under a signed BAA. It also enforces 42 CFR Part 2 SUD consent at the database layer — the AI cannot access substance use records without documented consent. Independent web application penetration test by Qualysec — April 2026, all findings closed at retest.

What is the pilot program?

A 30-day pilot at no cost to your facility — no platform fees and no infrastructure costs. Cendri covers the build, integration, infrastructure, and dedicated support. No commitment to continue. Before/after measurement you own: documentation time, authorization lift, preventable denials, prior-auth approval rates, and clinician satisfaction.

What percentage of behavioral health prior-auth requests are denied on first submission?

Behavioral health facilities collect roughly half of what their payer contracts already allow. Denial rates at our pilot facilities run 1.4% — the gap is in what was allowed, not what was denied.

What percentage of denied claims are ever appealed?

11.5% of prior-authorization denials are appealed, yet 80.7% of Medicare Advantage PA appeals are overturned when pursued (KFF analysis of CMS data, 2024).

How does Cendri's Payer Outcome Intelligence Engine work?

Cendri uses 24,276 claims baselined across two pilot facilities, 8 payer-specific medical necessity templates, and 5 ASAM level-of-care templates to draft prior-auth letters calibrated to each payer's documented preferences. Every approval and denial sharpens the next letter through a closed-loop learning system — 8 patent-pending claims, priority date locked April 2026.

How long does the Cendri pilot take?

The 30-day pilot starts with a 1-week onboarding phase (EHR data import, payer rules, baseline metrics), followed by a 3-week calibration phase, then full measurement. No cost to your facility — Cendri covers platform and infrastructure. No commitment to continue.

How Much of Your Contract Are You Actually Collecting?

Behavioral health facilities collect roughly half of what their payer contracts already allow. Not because claims get denied — denial rates at our pilot facilities run 1.4% — but because nobody checks whether what was paid matches what was allowed. EHRs write notes. RCM tools track claims. Neither one compares the clinical record to the remittance, so an underpayment looks exactly like a payment.

Calculate your facility's exposure below.

Your Contract Gap

Adjust the fields below to see the gap between what your contract allows and what you actually collect.

Number of Beds

Inpatient/residential

Average Per-Diem Rate

Median allowed per day of care, measured across 8,311 pilot claim lines

Annual Occupancy

Industry avg for residential BH

Net Collection vs. Allowed

Measured at a pilot facility. A healthy facility runs 95%.

Allowed by Contract

$4,304,719

Collected

$2,268,587

Gap Against Contract

$2,036,132

Modeled Recovery

$101,807

We price the contract gap at 5%, not at the gap itself. In our pilot's own remittance data, 85.1% of adjustment dollars are contractual obligation that is never collectable, 12.6% is patient responsibility, and 2.3% is payer-initiated. The pilot tells you your split before you chase anything.

What About Facilities With Contracted Rates?

Contracted rates set the ceiling — and nobody checks whether you hit it. The gap between allowed and collected is not a billing problem, it's a clinical-to-RCM disconnect. Cendri reconciles your documentation against what the payer actually remitted and classifies every dollar of the gap: contractual adjustment, patient responsibility, or payer-initiated. You see your split before you chase any of it.

Even in-network, you lose revenue to:

Underpayments vs. allowed

Payers remit below their own contracted amounts

Partial denials / days denied

Requested 14 days, authorized 7 — the gap is measured, not estimated

Never-billed claims

463 claims, $155,517 — payer field reads "unknown"

Expired filing windows

Process failure, catchable before submission

Documentation never received

Process failure, catchable before submission

Eligibility not met

Process failure, catchable before submission

The 30-day pilot measures the actual recovery on your claims — not industry averages.

Start the Pilot

From Our Pilot Facilities

52.7%

net collection against contracted allowed at a pilot facility

$84,881

preventable denials, coded and identified (133 claims)

24,276

claims baselined across two pilot facilities

Why Your Facility Loses Revenue You Should Have Collected

Two different denials, and only one of them is rare

Prior-authorization denials run 1.4% at our pilot facilities. Claim denials are separate and far more common: 501 of them closed with no recorded appeal outcome, and $84,881 across 133 claims were denied for pure process failures — expired filing windows, documentation never received, eligibility not met. But the largest gap isn't either one. It's underpayment: 52.7% net collection against contracted rates at a pilot facility, where a healthy facility runs 95%. A claim can be paid, recorded as paid, and still be wrong.

The Appeal Gap

11.5% of prior-authorization denials are appealed — most facilities don't have the staff time. (KFF analysis of CMS data, 2024)

The Win Rate You're Missing

When facilities do appeal, 80.7% of Medicare Advantage PA appeals are overturned — meaning the original denial was wrong. (KFF analysis of CMS data, 2024)

Preventable Denials

At one pilot facility, 133 claims and $84,881 were denied for process failures — expired filing windows, documentation never received, eligibility not met. Every one carries a reason code and is catchable before submission. The other pilot had 218 denials with no reason code at all — which is itself the finding.

Cendri's Clinical-to-RCM Reconciliation Engine

Cendri does not promise to recover every dollar. It bridges the gap between clinical documentation and revenue cycle — three specific, measurable things:

Reduce First-Pass Denials

Cendri uses 24,276 claims baselined across two pilot facilities, 8 payer-specific medical necessity templates, 5 ASAM level-of-care templates, and your facility's own approval/denial history to draft prior-auth letters that match each payer's documented preferences at the right level of care. Better first-pass authorization → fewer denials → less appeal work.

Make Appeals Faster & More Successful

When denials happen, Cendri auto-drafts appeal letters using the original denial reason + payer-specific overturn patterns from the outcome learning loop. Your team approves and sends instead of starting from scratch.

Learn Continuously

Every approval and denial sharpens the next letter. After 30 days of operational use, Cendri is calibrated to your specific payer mix and your facility's outcomes. The Save → Outcome → Appeal → Payer Intelligence loop is covered by our 8 patent-pending claims, priority date locked April 2026.

What We Don't Claim

We don't promise a specific dollar recovery without seeing your data. Here's what we will commit to in a pilot: a reconciled view of your collections against your own contracted allowed amounts, a classified list of every underpaid and unworked claim, measurable reduction in days-to-decision, and all AI endpoints included.

Typical Pilot Structure

Phase	Duration	What Happens
Onboard	1 week	EHR data import (CSV), payer rule import, baseline metrics captured
Calibrate	1 week	AI learns your payers from real outcomes, first prior-auths drafted
Measure	30 days	Approval-rate, days-to-decision, denial-rate deltas vs baseline
Decide	After day 30	Continue to multi-year contract or walk — no commitment. Your call

The 8 Payer Templates Shipped Today

Cendri ships with prior-auth and appeal templates pre-built for major payers across military, federal, state, and commercial channels, informed by 24,276 claims baselined across two pilot facilities:

Tricare (military health system)

Medicare (federal)

Medicaid (state-by-state variants)

UnitedHealthcare / Optum BH

Aetna

Blue Cross Blue Shield (multi-region)

Cigna

VA Community Care

Each template incorporates payer-specific medical-necessity language, ASAM-level documentation across all 5 levels of care (Detox, Residential, PHP, IOP, OP), and historical overturn patterns from the outcome baseline. 8 payers × 5 ASAM levels = 40 distinct authorization configurations.

Two Ways to Start

See It in 20 Minutes

Walk through the reconciliation workflow with a Cendri specialist using a simulated case from your typical payer mix.

Schedule Demo

Pilot at One Facility

30-day pilot at a single facility — no cost to you. We measure the contract gap and denial mix on your real claims. No commitment to continue until the data proves itself.

Talk to a Specialist

How Much of Your Contract Are You Actually Collecting?

Your Contract Gap

What About Facilities With Contracted Rates?

Why Your Facility Loses Revenue You Should Have Collected

Two different denials, and only one of them is rare

The Appeal Gap

The Win Rate You're Missing

Preventable Denials

Cendri's Clinical-to-RCM Reconciliation Engine

Reduce First-Pass Denials

Make Appeals Faster & More Successful

Learn Continuously

What We Don't Claim

Typical Pilot Structure

The 8 Payer Templates Shipped Today

Two Ways to Start

See It in 20 Minutes

Pilot at One Facility

Frequently Asked Questions