Cendri Health — The Clinical-to-RCM Bridge for Behavioral Health

The reconciliation layer between clinical documentation and revenue cycle for behavioral health and SUD facilities. Works alongside your existing EHR — Kipu, Sunwave, Epic, Cerner, Athena, Oracle Health, Netsmart — and adds what they aren't built to do: clinical-to-RCM reconciliation, payer outcome intelligence, AI-drafted auth letters and denial appeals, ambient Scribe, risk stratification, clinical co-pilot, and crisis detection.

The Reconciliation Gap: Revenue You Earned but Never Collected

Behavioral health facilities lose 15–30% of billed revenue to prior-authorization denials, write-offs, and documentation gaps. Cendri's Payer Outcome Intelligence engine turns every denial into training data, calculating per-payer approval rates, top denial patterns, and recommended request days from your facility's own outcomes. Built on 21,000+ payer outcome records. 8 payer-specific authorization templates: Tricare, Medicare, Medicaid, UnitedHealthcare/Optum, Aetna, Blue Cross Blue Shield, Cigna, VA Community Care. 5 ASAM level-of-care templates: Detox, Residential, PHP, IOP, Outpatient. Every approval, denial, and appeal sharpens the next letter.

• 15–30% of BH prior-auth requests denied on first submission (CMS, 2026).
• Fewer than 11% of denied claims are ever appealed — yet 80.7% of those appeals are overturned (CMS, 2026).
• 20M+ training scenarios across the corpus. 110+ clinical domains in production. 8 payer templates × 5 ASAM levels = 40 distinct configurations.

Platform Capabilities — 3 Portals, 25+ AI Endpoints

AI Scribe, Clinical Co-Pilot, CendriPredict (4-model risk engine), Care Concierge, UR Package Builder, ASAM Assessment Generator, Concurrent Review Brief, Peer-to-Peer Brief, Ask-the-Chart, Pre-Visit Brief, Treatment Tracker, Prior Auth Letters, Claim Audit + Appeal Generator, Payer Intelligence, Crisis Detection, AES-256-GCM PHI Encryption. Patient portal, Clinician portal, Administrator portal. One governance pipeline.

How Cendri Fits Your Stack

Your EHR stays the chart of record. Facility admin exports patient roster and claims history and uploads via the Admin Portal — most facilities are live in 2–4 hours. Your billing workflow stays in place — Cendri drafts auth letters and appeals, your team submits through your existing clearinghouse. A governed AI agent on top: Tier 2 clinical decision-support, purpose-built for BH/SUD, HIPAA-aligned, 42 CFR Part 2 enforced at the database layer. Ongoing sync: weekly delta CSV uploads; quarterly claims refresh keeps payer intelligence calibrated.

Security and Compliance

HIPAA-aligned on AWS under signed BAA. 42 CFR Part 2: SUD records gated at the database level. Qualysec pentest April 2026 — Grade A, Letter of Attestation on file. AES-256-GCM field-level PHI encryption for MRN, DOB, NPI, and emergency contacts at rest. JCAHO and CARF survey-ready documentation built in.

Pilot Program

30-day pilot — no cost to your facility. We cover the build, integration, infrastructure, and founder-level support. No commitment to continue. Selective with pilot facilities. Independent before/after measurement: documentation time, readmissions, PHQ-9 trajectories, prior-auth approval rates, and clinician satisfaction.

Cendri Health — About Us

Cendri Health™ is the reconciliation layer between clinical documentation and revenue cycle for behavioral health and SUD — patent-pending payer outcome intelligence, clinical-to-RCM reconciliation, AI authorization letters and denial appeals, ambient Scribe, 4-model risk engine (readmission, crisis, adherence, treatment-response), and wearable biometric integration. Works alongside your existing EHR via CSV import — live in 2–4 hours, no partner-program approvals required.

Behavioral health is a $92.14B market in the U.S. alone in 2026 (Fortune Business Insights 2026). Clinicians spend up to 45 minutes per encounter on documentation (JAMA/AMA, 2025). PHQ-9 scores, GAD-7s, encounter notes, and wearable data sit in separate systems with no connection between them. Cendri connects them. Mental Health Apps market: $8.64B in 2026 growing to $35.29B by 2034 at 19.23% CAGR.

Cendri connects to your existing EHR via CSV import on Day 1. Your facility admin uploads patient roster and claims history from your EHR's existing reporting tools, and Cendri ingests them into the AI engine. We add the reconciliation layer trained on 20M+ clinical scenarios across 110+ clinical domains, governed by a 10-stage pipeline, with wearable biometric integration and multi-model clinical risk stratification running continuously. Built specifically for behavioral health and SUD — not adapted from generic medical AI.

Why Generic AI Fails in Behavioral Health

Generic LLMs hallucinate treatment protocols, miss comorbidities, and give one-size-fits-all responses. Cendri is trained on BH data, governed at every response, and tuned to the patient in front of the clinician.

• Hybrid Retrieval, Not Hallucination: Hybrid keyword + semantic search across 20M+ BH scenarios injects validated clinical pathways into every AI response. One of 8 USPTO patent claims.
• 10-Stage Governance Pipeline: HIPAA/42 CFR gating, bias detection, C-SSRS crisis scoring, human-in-the-loop review, and immutable audit trail.
• Wearable to Clinical Bridge: ESI Score combines PHQ-9, GAD-7, and PCL-5 with wearable signals from 200+ devices — a single deterioration risk score updated daily.
• Physical-Behavioral Bridge: Detects how conditions amplify each other — PTSD, SUD, cardiometabolic risk — and adjusts all risk pipelines accordingly.
• Military and Cultural Readiness: VA/DoD/civilian routing. 18 auto-detected care barriers. 8 CDC race/ethnicity codes that change actual AI output.
• Faith-Based Care: The only BH AI platform with clinical content for religious trauma, moral injury, faith-integrated treatment, and denominational perspectives.
• 42 CFR Part 2 Compliance: SUD consent enforced at the database level — architectural enforcement, not a UI checkbox.

Built. Validated. Scaling.

• Phase 1 — Platform Built (Complete): 144K+ lines of code. 3 role-based portals. 25+ AI endpoints. 20M+ scenarios across 110+ clinical domains. 21,000+ payer outcome records. 8 payer × 5 ASAM templates. AWS with signed BAA.
• Phase 2 — Security and Compliance (Complete): HIPAA-aligned on AWS. 42 CFR Part 2 consent-aware governance. Qualysec pentest complete — Grade A. AWS WAF in production.
• Phase 3 — AI Enhancement and IP (Complete): Streaming responses, crisis auto-escalation, what-if analysis, retrieval quality gates. Prior-auth feedback flywheel live. 8-claim provisional patent filed with USPTO, April 2026.
• Phase 4 — Pilot and Scale (Live): First clinical pilots onboarding now (2026). FHIR testing across Epic, Cerner, Oracle Health, and Athena. National scale after pilot.

The Platform Moat

Clinical Depth: 110+ live domains (160 registered) — PTSD, SUD, TBI, MST, eating disorders, faith-based, adolescent, elderly, oncology, cardiometabolic, and more. Validated at Scale: Qualysec pentest complete — Grade A. All governance, retrieval, and payer intelligence test suites passing. Whole-Person AI: The only BH platform detecting comorbidity bridges, wearable signals, 18 care barriers, cultural modifiers, and faith integration simultaneously.

JCAHO and CARF Standards Built In

Survey-ready documentation. JCAHO: NPSG.15.01.01 (C-SSRS suicide screening at every encounter), PC.01.02.13 (biopsychosocial assessments flagged if missing within 24 hrs). CARF: CARF-BH-3.A.2 (SMART goals + person-served sign-off on every treatment plan), CARF-BH-3.E.1 (PHQ-9/GAD-7/PCL-5 flagged missing at intake).

Cendri Health Platform — The Clinical-to-RCM Bridge

The reconciliation layer between clinical documentation and revenue cycle for behavioral health. One platform. Three portals. Patent-pending closed-loop payer outcome intelligence — drafts payer-specific auth letters and denial appeals from your facility's actual claim history, then audits your clinical reality against real remittance data to recover what you already earned.

Payer-Specific Prior Authorization Intelligence

8 payer templates built in: Tricare, Medicare, Medicaid, UHC/Optum, Aetna, BCBS, Cigna, VA Community Care. 5 ASAM levels: 4.0 Detox, 3.x Residential, 2.5 PHP, 2.1 IOP, 1.0 Outpatient. 8 payers × 5 ASAM levels = 40 distinct authorization configurations. 21,000+ baseline outcome records — calibrates to your facility within 30 days.

Full UR Workflow — Live

From initial submission through peer-to-peer review and appeal — generated from your chart data.

• UR Package Builder: One-click continued-stay packet — LOC justification, ASAM, LOCUS, missing-data gaps, and reauth probability.
• ASAM 6-Dimension Assessment: AI-drafted scoring with severity rating, recommended level of care, and a printable payer-ready packet.
• LOCUS Synthesis: Composite score, recommended placement, and chart-grounded narrative — auto-generated from symptoms and functional indicators.
• Concurrent Review Brief: Day 7/14/21 continued-stay justification with score trajectories, progress, and requested days — formatted per payer.
• Peer-to-Peer Brief: Doc-to-doc talking points for payer medical reviewers, pre-loaded with anticipated pushback.
• Prior Auth Appeal Generator: Payer-tailored appeal targeting the specific denial reason with supporting clinical evidence.

Clinician Workflows

• AI Clinical Co-Pilot: Chart summaries, draft SOAP notes, after-visit instructions, and Ask-the-Chart Q&A — AI-generated, clinician-reviewed.
• CendriPredict Risk Engine: Readmission, crisis, adherence, and treatment-response risk — each scored 0–100 with AI explanation and what-if analysis. 4 risk models.
• Ambient Scribe: Records the encounter, generates a SOAP draft, and extracts ICD-10 codes — ready to copy into your EHR.
• Pre-Visit Brief: Opens when the chart loads — labs due, HEDIS gaps, C-SSRS prompts, and a draft medical-necessity paragraph.

Patient Touchpoints

• Validated Assessments: PHQ-9, GAD-7, AUDIT-C automatically scored and fed into the risk engine at intake and at defined intervals.
• Crisis Detection and Escalation: CendriPredict flags deterioration in real time — auto-escalates to the care team with safety resources delivered immediately.
• Wearable and Symptom Signals: HRV, sleep, and activity from 200+ devices via Terra API combine with mood and adherence tracking into a single daily risk score.

Admin Command Center — Six Purpose-Built Tools

• Prior-Auth ROI: Live approval rates, denial reasons, and recovered revenue tracked against your pre-Cendri baseline.
• Facility Onboarding: EHR-specific playbook for Epic, Cerner, Oracle Health, and Athena. Live in 2–4 hours.
• EHR Integration Validator: Paste a FHIR Bundle, get severity-tagged findings on structure, coding, and consent scope.
• Compliance Readiness: Live cross-check against HIPAA, 42 CFR Part 2, and SOC 2 with a per-control readiness score.
• Treatment Tracker: Auth-days remaining, expected transitions, and flagged alerts — UR and clinical teams in sync.
• Claim Audit + Appeal Generator: Pre-submission integrity scan plus a payer-tailored appeal draft on denial.

Infrastructure — Built for Production

What's live today: Payer Intelligence, Prior Auth and Appeals, Ambient Scribe, Risk Engine, Clinical Co-Pilot, UR Workflow, Crisis Detection, Treatment Tracker, Compliance Dashboard. Independent pentest complete, April 2026 — Grade A, Letter of Attestation on file. AES-256-GCM field-level PHI encryption, RBAC, MFA, and full audit logging. HIPAA-compliant. Signed BAA. 2–4 hours to go live.

Cendri Health — Market Opportunity

The U.S. behavioral health AI market is valued at $92.14B in 2026 (Fortune Business Insights 2026, 5.3% CAGR). Mental health apps specifically: $8.64B in 2026 growing to $35.29B by 2034 at 19.23% CAGR.

Market Drivers

• Documentation burden: clinicians spend up to 45 minutes per encounter on documentation (JAMA/AMA, 2025).
• Workforce burnout: 61% of healthcare workers report moderate-to-extreme burnout as of early 2026.
• Co-occurring conditions: 61.5 million U.S. adults had any mental illness in 2024, with 31.5% also meeting criteria for a substance use disorder (SAMHSA NSDUH, released July 2025).
• Prior-auth crisis: fewer than 11% of denied claims are ever appealed, yet 80.7% of Medicare Advantage PA appeals are overturned (CMS, 2026).
• AI funding: BH funding surged 38% in 2024 to $2.7B, with AI-focused deals leading growth (Rock Health Digital Health Funding Report, 2025).
• Federal mandate: CMS Prior Authorization Rule (CMS-0057-F) requires payers to process standard PAs within 7 days and urgent within 72 hours — effective 2026.

Competitive Landscape

Cendri vs. Cohere Health: Cohere is payer-side only, no clinical AI, no scribe, no risk engine. Cendri is provider-side with full clinical suite. Cendri vs. Kipu: Kipu is an EHR, no AI prior-auth intelligence, no risk engine, no wearables. Cendri vs. Netsmart: legacy EHR, no AI, no payer intelligence. Cendri vs. Eleos: Scribe-only, no payer intelligence, no risk engine, no wearables.

Cendri's differentiators: proprietary 20M+ clinical retrieval corpus, closed-loop payer outcome learning (patent-pending, 8 USPTO claims filed April 2026), 10-stage AI governance pipeline, 4-model risk engine, wearable biometric integration via Terra API, 110+ clinical domains including faith-based and military populations. Full UR workflow suite (UR Package Builder, ASAM 6-Dimension Generator, LOCUS Synthesis, Concurrent Review Brief, Peer-to-Peer Brief, Prior Auth Appeal Generator). Clinician tools: Ask-the-Chart, Pre-Visit Brief, Treatment Tracker, Claim Audit, Ambient Scribe.

Authorization ROI — Cendri Health Clinical-to-RCM Bridge

Behavioral health facilities lose 15–30% of billed revenue to denials, prior-auth churn, and documentation gaps. Most of that loss is preventable — the Clinical-to-RCM Bridge recovers revenue you already earned but have not collected.

• 15–30% of BH prior-auth requests denied on first submission (CMS, 2026).
• Fewer than 11% of denied claims are ever appealed (CMS, 2026).
• 80.7% of Medicare Advantage PA appeals are overturned when pursued (CMS Medicare Advantage Appeals Data, 2026).

Cendri's Payer Outcome Intelligence Engine uses 21,000+ outcome records, 8 payer-specific medical necessity templates, and a closed-loop learning system (Save → Outcome → Appeal → Payer Intelligence) to reduce first-pass denials, make appeals faster, and calibrate continuously to your payer mix. The Clinical-to-RCM Bridge audits your clinical documentation against real remittance data — classifying exactly why each unpaid claim is underpaid, denied, or recoverable.

30-day pilot available — no cost to your facility. Cendri covers platform and infrastructure. No commitment to continue. Independent before/after measurement on documentation time, prior-auth approval rate, PHQ-9 trajectory trends, 30-day readmission rate, and clinician satisfaction.

Contact Cendri Health

Email: info@cendrihealth.com

Address: 3472 NE Savanah Rd Suite 223, Jensen Beach, FL 34957