CoverageUnlocked Epic Integration

EHR Integration Roadmap

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Integration Roadmap

From Standalone to Epic-Embedded

A phased approach that delivers value immediately while building toward seamless EHR integration. Start analyzing denials today — integrate with Epic when you're ready.

Phase 1

Standalone Analysis

Available Now

LIVECurrent

Deploy CoverageUnlocked as a standalone web application. Your denial management team logs in, enters claim details, and receives predictive denial insights within seconds. No IT integration required.

Web-based UI

Accessible from any browser, no software installation

REST API

Programmatic access for existing RCM workflow tools

Bulk CSV Upload

Batch analysis of denial files exported from Epic

Instant Deployment

Can be operational within 24 hours of contract signing

Setup Time

< 24 hrs

IT Involvement

None

Analysis Speed

10-15s

Phase 1.5

FHIR API Integration

Epic Payer Platform

NEXTApr — May 2026

Connect to Epic's Payer Platform via FHIR R4 APIs to automatically ingest claim and denial data. Eliminates manual data entry and enables real-time denial detection as EOBs arrive.

FHIR R4 Resources

ExplanationOfBenefit, Claim, ClaimResponse, Coverage

Epic Payer Platform

Native integration with Epic's payer connectivity layer

Automated Ingestion

Denials detected and analyzed automatically as they arrive

OAuth 2.0 + SMART

Secure authentication following SMART on FHIR launch framework

Setup Time

2-4 weeks

IT Involvement

Moderate

Data Flow

One-way in

Phase 2

Bidirectional EHR Integration

CDS Hooks + Epic AppOrchard

PLANNEDQ3 — Q4 2026

Full bidirectional integration where analysis results flow back into Epic as clinical decision support alerts, notes, and worklist items. Appeal letters pre-populated with patient context.

CDS Hooks

Real-time alerts when a claim is at risk of denial BEFORE submission

Epic AppOrchard

Listed on Epic's marketplace for streamlined health system procurement

Results as Notes

Analysis and appeal letters written back to Epic as encounter notes

Worklist Integration

Denial tasks appear in existing Epic worklist queues

Setup Time

4-8 weeks

IT Involvement

Full

Data Flow

Bidirectional

Phase 3

Pre-Submission Scoring

Prevent Denials Before They Happen

PLANNEDQ1 2027

Shift from denial recovery to denial prevention. Score every surgical claim before submission for approval probability and automatically suggest documentation improvements to maximize first-pass approval rates.

Real-Time Scoring

Approval probability calculated as the claim is being built

Documentation Suggestions

AI-powered recommendations for missing documentation

Payer-Specific Rules

Auto-apply each payer's specific requirements and preferences

Network Intelligence

Cross-client pattern learning (federated, de-identified)

Latency Target

< 2 sec

Denial Prevention

30-50%

ROI Multiple

10-20x

Technical Architecture

Data Standards

  • FHIR R4 (HL7)
  • X12 835/837 (claims)
  • ICD-10-CM/PCS
  • CPT/HCPCS codes
  • CARC/RARC denial codes

Security Model

  • SMART on FHIR auth
  • OAuth 2.0 + PKCE
  • TLS 1.3 transport
  • Zero-knowledge PHI
  • BAA-ready architecture

EHR Compatibility

  • Epic (primary focus)
  • Cerner/Oracle Health
  • MEDITECH
  • Allscripts/Veradigm
  • Any FHIR-capable EHR

Ready to Start with Phase 1?

You can be analyzing denials within 24 hours — no IT integration needed. Epic integration comes when you're ready.

Discuss Integration Plan