Decision Intelligence

Technology OverviewHow It WorksCNLP APIIntelligent Document Processor (IDP)IntelliSync

Use Cases: payors

Prior AuthorizationUM & Clinical ReviewPayment Integrity

Use Cases: Providers

Risk Adjustment & RCMPopulation Health

Who We Serve

Health Plans & PayorsProviders & Health SystemsACOs & Value-Based CarePharma & Life Sciences

Company

About UsNews & RecognitionContactRequest a Demo →

Hindsait CNLP credentials:12+ Years Healthcare-Specific Training100M+ Records ProcessedHITRUST CSF Certified · HIPAA + SOC 2Twelve years of healthcare-specific training.

CNLP API · Foundation Layer

The Clinical NLP Engine Healthcare Has Been Waiting For.

Upload medical records. Receive structured, machine-readable clinical data. Hindsait's CNLP API extracts ICD-10/CPT codes, SNOMED terminology, medications, labs, diagnoses, and 50+ clinical entity types, from any unstructured document, in seconds.

Not a general NLP model adapted for healthcare. Twelve years of healthcare-specific training. 12+ years of rigorous training on healthcare-specific datasets, built specifically for the complexity, nuance, and stakes of clinical language. The hardest asset in healthcare AI. Competitors cannot compress 12 years.

Request API Access →Technology Overview

What the CNLP API Extracts

Send a record. Get structured clinical intelligence back.

Any accredited healthcare organization can securely submit medical records via API and receive a structured, machine-readable data feed, annotated, normalized, and ready for downstream integration.

Diagnoses & Codes

ICD-10 / CPT codes

SNOMED terminology codes

Clinical concept extraction

HCC risk adjustment codes

Medications & Labs

Medications, dosages, RxNorm

Lab values & vital signs

Prescription patterns

Allergy & contraindication flags

Procedures & Clinical

Imaging & lab report tags

Surgical notes & procedures

Screening & patient demographics

50+ clinical entity types total

Why CNLP API, Not Something Else

The moat that 12 years builds.

General-purpose NLP models can extract keywords. Hindsait's CNLP understands negation ("no evidence of pneumonia"), temporal context ("previously treated for"), clinical relationships ("secondary to"), and the semantic difference between a listed medication and an active prescription. That distinction matters in every clinical decision.

Healthcare-Specific Depth

Trained exclusively on clinical data, physician notes, discharge summaries, lab reports, operative notes, faxed records, not adapted from general text. Every model decision reflects healthcare context.

Clinical Context Intelligence

Handles negation, uncertainty, co-reference, and temporal reasoning, the linguistic complexities that cause general NLP to produce false positives in clinical review.

Compounding Data Moat

100M+ records processed since 2013. Every customer and every record improves the model. No competitor can replicate that training history, regardless of funding.

Integration-First Design

Real-time API with <200ms response. HL7 FHIR-compliant outputs. Connects directly to UM, PA, claims, EHR, and BI systems. Built to complement, not replace existing systems. Deployed in 6 to 8 weeks.

Frequently Asked Questions

CNLP API , Common Questions.

What document types does the CNLP API support? +

The CNLP API processes any clinical document type: physician notes, discharge summaries, operative reports, radiology and lab reports, pathology reports, faxed records, scanned handwritten notes, HL7 FHIR documents, and structured EMR exports. It supports PDF, image (TIFF, JPEG, PNG), plain text, HL7, and CCD/CCDA formats.

How is this different from using GPT or a general large language model? +

General LLMs are trained on broad internet text and adapted for healthcare as an afterthought. Hindsait's CNLP was trained exclusively on clinical documentation from 2013, physician notes, operative records, lab reports. It understands clinical negation ("no evidence of"), temporal context ("history of"), uncertainty markers, and co-reference resolution specific to medical language. General LLMs produce false positives in clinical settings that make them unsuitable for production decisions. Hindsait's CNLP is purpose-built for clinical evidence extraction and audit-ready prior authorization workflows, not generic text generation.

How long does the API take to process a document? +

Standard clinical documents (1–30 pages) are processed in under 30 seconds, with API response times under 200ms for structured output delivery. Large chart packages (100+ pages) are processed in batch mode with real time status updates. The system scales horizontally to support population-level processing of thousands of records simultaneously.

What security and compliance certifications does the API carry? +

The CNLP API is HITRUST CSF Certified, HIPAA compliant, and SOC 2 audited. All data is processed on HIPAA-compliant Google Cloud Platform infrastructure with end-to-end encryption in transit and at rest. BAA agreements are available for all healthcare customers. The API supports production prior authorization workflows at WPS Health, a leading Medicare Administrative Contractor.

How does the CNLP API integrate with existing systems? +

The API is HL7 FHIR-compliant and delivers structured JSON output that connects directly to claims systems, UM/PA platforms, EHRs, audit systems, and BI dashboards. Integration is built to complement, not replace existing systems Most customers are live within 6 to 8 weeks. RESTful API with complete documentation and sandbox access available upon request.

Who can access the CNLP API? +

The CNLP API is available to accredited healthcare organizations, health plans, Medicare Advantage plans, Medicaid MCOs, hospital systems, ACOs, physician groups, TPAs, health IT vendors, and pharmaceutical companies. Access requires a completed data use agreement and BAA. Contact info@hindsait.com or submit the demo request form to begin the access process.

Ready to access the CNLP API?

12+ years of healthcare-specific NLP. 100M+ records processed. Built for production prior authorization workflows. 6 to 8 week deployment.

Request API Access →Technology Overview

This Is What Healthcare AI Should Look Like.

Production-deployed with WPS Health. Audit-ready by design. Proven to reduce prior authorization review time by 53%. Hindsait turns clinical records into decision-ready intelligence for prior authorization, clinical review, and payment integrity.

Gartner® recognized, built on 12 years of healthcare-specific clinical NLP, and shaped by 100M+ medical records processed across real clinical workflows.

Request a Demo →See How It Works

53%Prior Auth (PA) EfficiencyDocumented across real PA deployments

100M+Medical Records ProcessedSince 2013, across real clinical workflows

12 yrsHealthcare-Specific AI R&DCNLP trained on clinical data since 2013

3×Faster PA DecisionsTurnaround time across deployed health plans

6–8 wksWeeks to Live DeploymentBuilt to complement, not replace existing systems

PALIVE

Live in ProductionProduction-deployed prior authorization (PA) workflows with audit-ready clinical oversight

Gartner®

2026 Representative VendorGartner Market Guide for Intelligent Prior Authorization, inaugural edition

HITRUST CSFCertified InfrastructureHIPAA + SOC 2 · Enterprise-grade PHI protection at every layer

WPS Health SolutionsLive Production ClientMedicare Administrative Contractor · Jurisdictions 5 & 8

Florida BlueStrategic InvestorGuideWell · One of the largest Blues Plans in the country

Why Hindsait Is Different

Clinical AI that has earned its place in production.

Production deployment in prior authorization requires evidence, controls, and auditability—not marketing claims. Automated evidence matching for clinically clear cases.

With Florida Blue among our strategic backers and twelve years of healthcare-specific CNLP training, Hindsait brings accumulated clinical intelligence built through years of real clinical data, deployment, and refinement.

01

Proven at production scale

100M+ records processed. Live in production at WPS Health, a Medicare Administrative Contractor, processing real PA workflows. Already operating in live authorization workflows.

02

Human-in-the-loop where it matters

Automated evidence matching for clinically clear cases. Clinician review for complex determinations. Live in 6–8 weeks, built to complement, not replace your existing UM, PA, EHR, or claims systems.

03

53% PA efficiency. Verified.

A documented outcome across real deployments, not a modeled projection. Measured across prior authorization and clinical audit workflows, the Hindsait platform delivered 30% time savings.

04

Flexible Deployment. Your Environment, Your Terms.

Deploy on-premises or on cloud — GCP, AWS, or Azure — based on your data governance and security requirements. Same platform, same clinical intelligence, same audit trail. No vendor lock-in. No forced migration.

Production Deployment · Prior Authorization

53%

Efficiency improvement across prior authorization and clinical review workflows

Live in production at WPS Health, a Medicare Administrative Contractor for Jurisdictions 5 & 8. Automated evidence matching where clinical criteria are conclusively met. Clinicians in the loop for complex determinations.

"

Having the Hindsait team deeply integrated with our operational SME's, we were not only able to cut our medical review time by over 50%, we also developed new and novel additional uses and custom capabilities with the Hindsait platform to add greater value to our organization, staff, and customers.

BJ

Brian Janssen

Chief Information Officer, WPS Health Solutions

Download the White Paper →

How Hindsait Works

Clinical intelligence, built in layers.

Every Hindsait decision starts with the same foundation, structured clinical intelligence extracted from the documents you already have. One base layer. Every use case above it.

Use Case Layer, Powered by IDP Clinical Intelligence

Prior Authorization

PA decision support. Criteria-matched. Audit-ready. Human-in-the-loop for complex cases.

Production Deployed3× Faster

UM & Clinical Review

MCG, InterQual, LCD/NCD criteria applied consistently across every concurrent and retrospective review.

Guideline-Aligned30% Time Savings

Payment Integrity

Claims anomaly detection, post-payment clinical review, FWA pattern analysis across your full population.

FWA DetectionPopulation Scale

Risk Adjustment & HCC

HCC coding gap identification, RAF score optimization, and RADV-ready audit trail for ACOs and health plans.

RAF OptimizedRADV-Ready

Revenue Cycle & Coding

Automated ICD-10 to HCC crosswalk, AI-assisted coding with human review, and provider prior authorization.

HCC CrosswalkAudit-Proof

Population Health & More

HEDIS, Stars, SDOH analytics, quality oversight, ACO performance, pharma market access, and RWE.

HEDIS / StarsQuality & Pharma

Structured clinical intelligence feeds every use case above

Foundation Layer

Hindsait IDP

Intelligent Document Processor

One foundation layer, every use case above it. IntelliSync, our automated policy intellgence layer, continuously monitors CMS, payor policies, and clinical guidelines, so every decision the pipeline produces is always aligned to current criteria, without manual updates.

Explore IDP →

Ingest

Any source

any format

Clinical NLP

Context-aware

understanding

Extract & Summarize

Key facts

GenAI summary

Score & Route

Evidence strength

smart routing

Deliver

Real-time API

audit trail

95%

Extraction

Accuracy

<30s

Per

Document

50+

Clinical

Entity Types

Who We Serve

Built for every side of the clinical decision

One platform. Three distinct solution sets, each designed for the workflows, pain points, and buyers that define that segment of healthcare.

Payor Solutions

Health Plans & Payors

Automate PA, UM, clinical audit, and payment integrity while meeting CMS-0057-F mandates and HEDIS benchmarks, without adding headcount.

  • CMS-0057-F compliant PA automation
  • MCG, InterQual, LCD/NCD decision trees
  • Payment integrity & FWA detection
  • HEDIS & Stars gap analytics

Explore Payor Solutions →

Pharma Solutions

Pharma & Life Sciences

Accelerate specialty drug access, decode payor policies , and extract real-world clinical evidence to power market access strategy.

  • Specialty drug PA automation
  • payor policy monitoring, 100s of plans
  • Real-world evidence extraction
  • HEOR & outcomes analytics

Explore Pharma Solutions →

Provider Solutions

Providers & Health Systems

Reduce claim denials, cut documentation burden by 40%, and optimize ACO and value-based care performance from one clinical intelligence layer.

  • AI documentation, 40% burden reduction
  • Denial risk scoring pre-submission
  • MIPS, Stars, HEDIS gap analytics
  • Predictive readmission alerts

Explore Provider Solutions →

Results & Recognition

Trusted by healthcare's most demanding organizations

Magellan Health](https://www.magellanhealth.com/) WPS Health Solutions](https://www.wpshealth.com/) NY Blood Center](https://www.nybc.org/) GuideWell Innovation](https://guidewellinnovation.com/) Hackensack UMC](https://hackensackmeridianhealth.org/en/locations/hackensack-university-medical-center)

"

Hindsait's technology and creative approach have opened new doors in how we use data to manage our business.

Tina Blasi

CEO, NIA / Magellan

"

Hindsait’s proven AI technology and differentiated platform, coupled with its seasoned executive team, set it apart.

Ateet Adhikari

Vice President, Healthbox

"

We worked with Hindsait to fine-tune predictive analytics that would enhance our efficiency without compromising quality.

Laurel Douty

COO, Magellan Healthcare

"

Hindsait's ability to identify meaningful clinical insights creates a better pathway for care delivery across our entire network.

Renee Finley

Head of Innovation, GuideWell

"

Having the Hindsait team deeply integrated with our operational SME's, we were not only able to cut our medical review time by over 50%, we also developed new and novel additional uses and custom capabilities with the Hindsait platform to add greater value to our organization, staff, and customers.

Brian Janssen

Chief Information Officer, WPS Health Solutions

Gartner 2026 Market Guide](https://www.gartner.com/en/documents/7430962) Forbes Healthcare AI Recognition](https://www.forbes.com/councils/forbesbusinesscouncil/2023/11/28/how-ai-is-transforming-healthcare-risk-adjustment/) Gartner Cool Vendor 2017](http://www.prnewswire.com/news-releases/hindsait-inc-named-a-cool-vendor-in-ai-in-healthcare-by-gartner-300465248.html) HITRUST CSF Certified](https://www.newswire.com/news/hindsait-achieves-hitrust-csf-certification-to-manage-risk-improve-21141491) Frost & Sullivan Best Practices Award](http://www.prnewswire.com/news-releases/frost--sullivan-applauds-hindsait-for-pioneering-healthcare-centric-artificial-intelligence-systems-300280393.html)

Proven Outcomes

Efficiency without compromising quality

Every metric to the right comes from a real Hindsait client deployment, not modeled projections. Healthcare Decision Intelligence delivers measurable ROI within the first quarter of deployment.

Built for the buyer who counts cost per review. Hindsait clients report measurable FTE reallocation, faster turnaround, and reduced rework, translating directly to lower administrative cost per clinical decision.

Faster PA Processing

Turnaround time across deployed health plans

+30%

Medical Review Efficiency

WPS Health Solutions deployment

35%

Unnecessary Cost Reduction

Evidence-based AI applied to utilization review

53%

Prior Auth (PA) Efficiency

Documented across real PA deployments

+24%

First-Pass PA Approval Rate

payor-aligned submissions, first time

98%

Decision Consistency

Uniform determinations across every reviewer

News & Recognition