SolutionsRCM
Turn your RCM processes into AI agents
Trail parses payer policies, provider contracts, coding guidance, denial letters and your appeal playbook into one governed context graph. Then AI agents run denials, appeals, prior authorization and eligibility on top of it — with PHI held inside your own boundary.
Denials & appeals
This week- 412denials worked
- 96appeals filed
- 31windows < 14d
- 89%auto-worked
- CLM-77108Northwind Health$2,940Refiled—
- CLM-77190Cascade Mutual$16,450Drafting—
- CLM-77214Fairmont Health Plan$4,180HeldA. Reyes
- CLM-77302Granite State Health$9,720ApprovalL. Osei
- CLM-77341Bellcourt Health$1,265Refiled—
Trusted by teams at leading enterprises
Top revenue cycle teams
put Trail to work on:
Turn a payer policy into a working agent — in one upload.
Import the payer medical policy, provider contract or appeal playbook your denials team maintains. Trail reads it, builds the agent, and shows which clause produced each rule.
- 01
Import process docs
Drop in the payer policy, provider contract or appeal playbook your team already maintains — PDF, DOCX, portal exports.
- 02
Agent auto-built
Trail parses them into a context graph. It outlines the agent's role, splits the process into phases, and adds the tools each step needs.
- 03
Review, approve, run
Every learned rule is explained and traced to the exact text it came from. Agents take decisions strictly based on these rules.
“…covered services shall be reimbursed at the contracted rate set out in Exhibit B, less applicable member cost share; where a remittance advice reflects an allowed amount below that rate, the difference shall be treated as an underpayment and reprocessed on provider notice…”
If a posted line's allowed amount is under the Exhibit B rate, flag it as an underpayment and notice the payer..
One graph underneath all your AI agents.
Everything Trail parses collapses into a single governed graph, and everything your revenue cycle teams automate draws from it, whether the work runs in autonomous agents or copilot chats.
Agents - run processes autonomously
- ObserveCLM-77214 | CO-50 · Payer policy §3.4
- ReasonNecessity denial, auth on file. Day 41 of 60
- ActionLevel-1 appeal drafted for review
- ObserveREF-2208 · lumbar MRI · Medical policy §7.2
- ReasonSix weeks of conservative care documented
- ActionAuth request filed with the chart notes
- ObserveMember 4471, pre-service · Plan benefits §2.1
- ReasonSecond plan active since 1 Jan. COB wrong
- ActionOrder of benefits fixed before billing
- ObserveCLM-77302 | CO-16 · Coding guideline §5.3
- ReasonModifier 25 unsupported by the visit note
- ActionQuery sent to the provider, code held
Copilot Chats - ask questions and run tasks
Help your agents solve the most complex problems with context graphs.
A claim denied for medical necessity on a plan with a 60-day appeal window is now at day 41, with a prior authorization noted by the clinic — is it appealable, and how?
One question. Five kinds of context, each in a different system — four of the answers change by payer, and the fifth is a clock.
How the Context Graph works →Payer policy documents
Policy context · What does this payer require?
Necessity criteria + authorization reference
Payer & plan records
System-of-record context · Which plan, which window?
60-day window · level-1 appeal
Denial dates
Computed context · How much time is left?
19 days remaining
Clinic correspondence
Conversation context · What's actually on file?
Prior auth obtained 12 Feb
Appeal playbook
SOP context · Which path?
Level-1 appeal with auth + necessity letter
Connects to the agent platform you already use.
Point the agents your revenue cycle org already runs, SAP Joule, Agentforce, Copilot, Claude or your own stack, at one Trail brain, through a native Model Context Protocol server, native retrievers, or a plain REST/GraphQL API. Add or switch platforms without re-teaching a thing.
35% of Fortune 500 and 10,000+ companies use Trail
Customer story · PayGround
“Nanonets streamlined processing, saved considerable time and resources for us. There was visible difference in app performance; we appealed to customers by making bill payment easy.”
- Per bill
- 3 min → 10 sec
- Fields keyed by hand
- 6–10 → 0
- Touchless processing
- 100% of bills
- Extraction accuracy
- 99% across 100+ facilities
Teams using Trail see
- 95%Straight-through processing
- 80%Reduction in associated costs
- 15×Quicker turnaround times
Built for how modern
enterprises work.
Trail meets the highest industry standards for your security & compliance. We include all default controls that you'd expect, including SAML SSO, audit logs, IP allow-listing, data lifecycle management, and much more.
- SSO & SCIM
- SAML, OIDC, and SCIM user provisioning with Okta, Azure AD, Google Workspace.
- Role-based access
- Full RBAC and fine-grained access control across orgs, workspaces, agents.
- Audit logs
- Every agent run, approval, and data access is recorded, and streams to your SIEM.
- Private deployment
- VPC, single-tenant cloud, or on-prem. Choose your infrastructure and network policies.
- Data residency
- Pin data processing to US, EU, APAC regions. Customer data never leaves your boundary.
- Human-in-the-loop
- Configure approval gates to route edge cases to Slack, Teams, or email for review.
- Encryption at rest & in transit
- AES-256 at rest, TLS 1.3 in transit. BYOK supported for all customer-managed keys.
- Usage quotas & rate limits
- Per-team budgets and API quotas with real-time cost dashboards. No surprises.
Security built in, not bolted on.
Your data and your company brain never leave your boundary. Independently audited every year, with compliance controls enforced by the platform — not promised on a page.
Held and current — not roadmap targets.
SOC 2 Type IIOngoing security controls
GDPREU data protection
ISO 27001Global ISMS standard
HIPAABAA on enterprise plansTurn your RCM processes
into a competitive advantage.
Bring one payer policy and one denied claim. We'll show you how Trail proposes rules and builds an agent, which then takes the correct decision and acts on it.
Prefer to read first? Read the FAQ →