Ship Payer Rule Changes Without a Redeploy

Externalize fee schedules, adjudication logic, denials classification, and compliance rules into a governed decision layer — versioned, approved, and traceable, without tying every payer update to your release cycle.

Versioned Rule Changes, Maker/Checker Approvals, Denial Reason-Code Logic, Effective-Dated Rollouts, Parallel Run / Shadow Mode, Full Audit Trails
  • Real-Time Assessment using API Connector
  • Customize Scoring Rules in No-code/low-code
  • Automated Decision-making via CRON
  • Built Complex Scoring Models in Minutes
  • Integration with Third Party Systems
  • Iterate Conditions Instantly
Revenue Cycle Management (RCM) Automation
Trusted by teams across 500+ companies globally
PROBLEMS
52% reduction in misroutes within 30 days of rule automation

Fee Schedules Buried in Code

Reimbursement and contract rules sit hardcoded across services, so a routine Medicare/Medicaid update turns into a multi-team release.

Adjudication Logic Locked in Legacy Systems

Payer-side rules are scattered across siloed systems, so even a small policy change carries outsized engineering and compliance risk.

Denials Classification Lives in Spreadsheets

Reason-code logic works fine until claim volume grows — then it turns inconsistent, hard to govern, and nearly impossible to audit.

Audit Requests Turn Into Archaeology

Proving which rule version produced a given claim outcome means digging through logs and tribal knowledge instead of pulling a clean record.

Rule Changes Coupled to Release Cycles

Because payer logic lives inside the application, every update queues behind platform work and deployment windows.

No Way to Prove Parity Before Going Live

Without shadow-mode validation, new rules go live untested against real claim patterns — issues only surface after they've already shipped.

SOLUTION

Externalize the Part of RCM That's Actually Logic-Heavy

Fee Schedule & Contract Rule Engine

Model reimbursement, fee schedule, and contract logic in decision tables and rule chains — versioned, diffable, and approved before publish.

Claims Adjudication Abstraction

Centralize payer-side adjudication logic outside your core services, so a policy update doesn't require a platform release.

Denials Classification & Reason Codes

Turn spreadsheet-driven denial logic into governed, explainable rules with built-in reason-code tracking and execution tracing.

Audit & Compliance Validation

Every rule ships with maker/checker approval, full version history, and decision traces — so audit requests take minutes, not a reconstruction project.

TESTIMONIAL

Trusted by Both Tech & Non-Tech Teams

80% Faster
Development  for our system

Nected lets us move faster than building everything in-house. With their cloud solution, URLs for staging and production are automatically set up, so we have no DevOps overhead. This speeds up development and cuts maintenance.

Greg R.
Tech Lead
SidecarHealth
2x Faster
Time to Market

Nected reduced development time by 2x and it has made our system much more modular and flexible as compared to hard-coded systems, reducing our continuous dependency on tech.

Souradeep Paul
Director of Product
Brightchamps
50% Faster
Sprint Cycle in overall

Nected’s modular rule engine and workflow system streamline complex payout calculations, achieving 3.2x faster development and cutting rollout timelines by weeks.

Ayan S.
Chief Product Officer
Wealthright
Zero
Tech Bandwidth required

Nected transformed our operations at Torch. Within hours, we integrated our systems and Google Sheets, enhancing our pricing rules workflow significantly. Nected transformed our operations at Torch.

Joe Shoop
Director Of Engineering
Torch 3PL
4x Faster
decisioning with Nected

A crucial factor for successful implementation of rules engines is when it is a customized or bespoke solution tailored for technical users, ensuring a higher level of depth, flexibility, and change tracking capabilities.

Sandeep Arora
Chief Technology Officer
Nupay
4% Growth
in conversions in 2 weeks

Nected has transformed our workflow by accelerating feature deployment by 30% and eliminating repetitive tasks. The platform's clean and intuitive interface adds to the overall experience, making it a joy to work with. We saw a 3% rise in leads and 4% growth in conversions within 20 days.

Raman Kumar
CTO & Co-Founder

Vidyakul

Ship Payer Rule Changes With Confidence, Not Redeploys

The first sprint looks cheap. The second year reveals the real cost structure: developer hours on maintenance, infrastructure at scale, governance retrofitting, and the compounding tax of a system that wasn't designed to be a product but became one anyway.

HOW TO BUILD

Model, Validate & Roll Out Payer Rules — With Governance Built In

Model the Rule

Build fee schedule, adjudication, or denial-classification logic in decision tables and rule chains — or describe it in plain English and let AI Copilot draft the first version for your team to review.

Validate in Parallel

Run the new rule in shadow mode against real or replayed claims data to prove parity with your current logic before anything goes live.

Roll Out by Payer or Segment

Publish with effective dating, targeting specific payers, customers, or segments, not an all-or-nothing release across your whole book.

Trace & Audit

Every decision carries its rule version and execution trace, so support and compliance can answer "which rule produced this outcome?" in minutes, not a manual reconstruction.

Built for Builders, Trusted by Experts

Nected isn't just another automation tool. We're the fix for rigid, outdated decision engines that slow your team down.

Joe Shoop
Director of Engineering
Spent months fighting our old rule engine. Every minor change meant bothering developers. Now we just update pricing when we need to. No bottlenecks.
James W.
Director of Product
Compliance used to be a nightmare. Our last tool barely had audit logs. With Nected we actually see who changed what. And rolling back is easy. This part often gets ignored by other tools, but here it just works.
Michael T.
Director of Engineering
Trying to scale the old setup was brutal. Expanding to new regions meant hitting API limits and random downtime. Nected handles the multi-region stuff. We launch in new markets now without the usual panic.
Olivia B.
Senior Product Manager
Constant delays and weird, inconsistent results. Used to kill our momentum entirely. Now it just processes the volume instantly.
William S.
Business Head
Lost deals because we couldn't do custom pricing fast enough. Competitors were getting ahead. Switched to Nected and that changed basically overnight. Sales finally has the flexibility they kept asking for.
Ava K.
Director of Engineering
It doesn't box you in. Hooks into whatever stack you already have via API.
Ethan D.
Business Head
Felt like we were running software from 2005 before. Clunky and slow.
Sophia L.
Senior Product Manager
You don't realize how bad your setup is until you replace it. Stuff that used to take days of manual tweaks and endless back-and-forth happens in minutes now. Dropped our error rate. System finally moves at our pace.
Free to start, and affordable as you grow!
Check Pricing Plans
FEATURES

Modern Decision Engine Built for Enterprise Scale

No Code Connectors

Seamlessly integrate with any system using simple API-based connectors. No need for complex configurations—connect databases, third-party services, and internal tools with just a few clicks.

Multiple Rule Types

Leverage a powerful rule engine with multiple rule types, including Simple Rules, Decision Tables, Decision Trees, Rule Sets, and Rule Chains to handle complex logic effortlessly.

Workflow Automation

Build any complex workflows & orchestrtation using Code, Database, and REST API Nodes, while Action nodes like Loop, Delay, and Switch Operations.

Development Lifecycle

Efficiently oversee the entire rule and workflow lifecycle with built-in versioning, git sync, rollback capabilities, and staging environments, ensuring seamless transitions from testing to production without disruptions.

Cloud-Native Deployment

Deploy Nected anywhere—choose multi-region cloud hosting for high availability or self-host on your infrastructure for complete control and compliance.

Monitoring & Reporting

Gain full visibility into your decision rules and workflows with audit trails features, and real-time dashboards. Stay compliant and track every change with ease.

White Labelled Solution

Deliver a fully white-labeled experience with embedded user functionality. Use Nected as your own branded decision engine.

Enterprise-Grade Security

Operate with confidence using enterprise-level security, role-based access control, and scalable infrastructure that ensures data integrity and performance even at scale.

AI Agents

Deploy intelligent AI Agents to automate document extraction, text classification, data enrichment, or any other domain-specific task. Build your own agents or plug in pre-trained ones directly into your workflows.

Build with AI Copilot

With our AI Copilot feature now you can build your rules and workflows with plain simple prompts or by uploading your PRD

FAQs

How is Nected different from a traditional RCM rules engine?

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Traditional claims editing sits hardcoded in Java or locked inside a legacy BRMS, so every payer policy update needs an engineering sprint. Nected externalizes that logic into a no-code rule layer, and its AI Copilot goes a step further—describe a payer policy in plain English or upload the PRD, and it drafts the coding, eligibility, or prior-auth rule for you. Billing teams review and publish it directly, no developer required.

Can billing and compliance teams build rules without engineering help?

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Yes. Nected's visual rule builder, AI Copilot, role-based permissions, and versioned rollback mean billing, coding, and compliance teams can author and update payer-specific rules on their own—while every change stays logged, timestamped, and auditable for compliance review.

How does document intelligence and OCR fit into claims processing?

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Nected's built-in document intelligence and OCR read scanned claim forms, EOBs, and faxed prior-auth requests, extracting structured data straight into the rule engine. That removes manual keying from intake, cuts transcription errors, and lets downstream rules run the moment a document lands.

Can Nected catch denial-prone claims before they're submitted?

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Yes. Built-in AI agents check claims against live payer rules pre-submission, flag denial-prone patterns by plan, specialty, or location, and suggest fixes. Paired with scenario simulation against historical claims, teams catch coding and eligibility issues before they turn into rework.

How fast can we go live with RCM rules on Nected?

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First rules typically go live in under 30 minutes using the AI Copilot and prebuilt connectors. Full production rollouts—covering EHR, clearinghouse, and payer portal integrations—usually take days, not the sprint cycles a hardcoded system requires.

What systems does Nected integrate with for RCM workflows?

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Nected offers pre-built connectors for major EHRs, clearinghouses, payer portals, and claims scrubbers, plus REST APIs for anything custom. Rules can pull eligibility, coding, and coverage data in real time without a point-to-point integration project for every payer.

How does Nected handle audit and compliance requirements for RCM?

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Every rule change—AI-drafted or manually authored—is logged with author, timestamp, diff, and approval history, with one-click rollback if a payer reverses a policy. Nected is SOC 2 Type 2, GDPR, and ISO 27001 certified, with RBAC, encryption, and full audit exports built in.

What do you mean by invocations? And how is it better than other products?

Invocations refer to the number of times your workflows/rule is triggered via API, cron or other trigger. It will count the parent rule/workflow and can have as many rules, nodes within it. This metric is often used for billing purposes. Compared to other products, invocations as a billing metric can be more cost-effective and transparent, aligning closely with your actual usage and needs. It ensures you pay for the value you receive, rather than flat rates or less relevant metrics.

What if I exceed my plan quota?

If you exceed, you'll be charged based on additional usage and will be added in your monthly charge. In case of payment failure after grace period, your plan will be reverted to free trial limiting your monthly execution and # of rules/flows as per free plan, however all your existing rules/workflow data would be kept intact.

What if I decide to cancel? Can I cancel anytime?

Firstly, we do not have a vendor lock-in, so you can cancel anytime you want. However, if you decide to cancel once your subscription for a given period has started then you would be able to cancel at the time of the next billing cycle only.

Can I upgrade my plan in between?

Yes, you can typically upgrade your Nected plan at any point during your billing cycle. The upgrade process is usually straightforward, often involving just a few clicks in your account settings. Upgrading mid-cycle may involve prorated charges for the higher-tier service.

Which plan should I go for?

The best plan depends on your specific needs, such as the expected number of invocations, the complexity of your workflows, and the level of support you require. It’s a good idea to start with a basic plan and upgrade as your needs evolve, especially if you're new to Nected. Moreover, you can also write to us at assist@nected.ai and we will help you figure out the best plan for your brand.

Would I be getting assistance in setting up Nected or building my POC?

Yes, Nected usually offers assistance in setting up and creating a Proof of Concept (POC), especially under certain plans. This assistance can include access to customer support, documentation, and possibly dedicated account management.

What level of support does the Startup and Growth plan have?

The Startup and Growth plans typically provide basic to enhanced support, including access to customer service through email or chat, a knowledge base, and possibly community forums. Response times and the extent of personalized assistance may vary between these plans.

What level of support does on-premise plan have?

The on-premise plan generally offers the most comprehensive support, including dedicated account managers, 24/7 support, and tailored assistance for deployment, maintenance, and troubleshooting. This plan is best suited for businesses with extensive, mission-critical use of Nected.

Free to start, and affordable as you grow

Our experts can help you build!
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