Build on financial decisions, not raw claims.

Cenrus turns payer adjudication, provider requests, and available payment evidence into a structured verdict for your product. Integrate Cenrus through a workflow-specific API engagement.

Discuss API access See how it works

result.json

"verdict": "amount_discrepancy"

"provider_requested": "440.00"

"payer_responsibility": "193.24"

"recommended_action": "review_discrepancy"

Send the records you have. Receive the decision they support.

Cenrus keeps raw source records available as evidence, but the core product is the reconciliation result.

Inputs

Payer adjudication
Patient-authorized claims and EOB financial data from supported connections.
Provider request
Bill or statement data, account context, service details, and requested balance.
Payment evidence
Customer supplied receipts, transactions, or other supported records.

Outputs

Verdict
Compared values
Match signals
Confidence
Evidence
Next action
Change events

A result designed for software and reviewers.

The response keeps machine-readable fields next to the evidence a reviewer needs. The response schema is finalized during integration.

Synthetic example.

application/json

{
  "reconciliation_id": "rec_02f27_sample",
  "status": "review_required",
  "verdict": {
    "code": "amount_discrepancy",
    "summary": "Provider request exceeds payer assigned patient responsibility.",
    "confidence": "high"
  },
  "financial_comparison": {
    "currency": "USD",
    "provider_requested": "440.00",
    "payer_patient_responsibility": "193.24",
    "difference": "246.76",
    "known_patient_payments": null
  },
  "match": {
    "status": "supported",
    "signals": [
      { "type": "patient_account", "result": "exact" },
      { "type": "service_date", "result": "exact" },
      { "type": "provider", "result": "supported" }
    ]
  },
  "evidence": {
    "payer_adjustment": "246.76",
    "deductible": "193.24",
    "copay": "0.00",
    "coinsurance": "0.00"
  },
  "recommended_action": {
    "code": "review_discrepancy",
    "reason": "The payer record does not establish the provider's current balance."
  }
}

React when the underlying state changes.

Cenrus sends event data through the delivery pattern defined for the integration. Customer systems update cases without polling every source record.

claim.changed

The observed payer claim has a new version or financial state.

responsibility.changed

The payer assigned patient responsibility changed.

reconciliation.completed

Cenrus produced a result for a submitted case.

review.required

The case needs a reviewer because of a discrepancy, ambiguity, or evidence gap.

Connect payer data with the patient's approval.

The reconciliation workflow depends on patient-authorized access to supported payer data. Cenrus treats connection state and data availability as part of every result.

Customer starts authorization

The customer workflow identifies the person and the payer connection needed for review.

Patient approves access

The patient completes the authorization path provided for the supported payer source.

Cenrus synchronizes records

The engine retrieves and maintains the payer records available through that connection.

Results state data limits

A missing, expired, or insufficient connection changes the verdict and next action.

Move from sample cases to a controlled workflow.

The implementation process establishes data availability, match quality, verdict agreement, and operating rules before Cenrus handles a production path.

01
Define the workflow
Map the customer queue, review rules, authorization path, and the decisions Cenrus returns.
02
Connect pilot data
Use patient-authorized payer access and a controlled set of provider bills with known reviewer outcomes.
03
Run side by side
Compare match results, verdicts, evidence, and reviewer agreement without changing production handling.
04
Set decision rules
Agree on confidence thresholds, escalation paths, event handling, and the cases that stay with a person.
05
Integrate the workflow
Return results and changes to the customer system through the interface defined for the pilot.

Cenrus API

Define the integration around a real financial workflow.

Tell us what records your product has, what decision it needs, and how the result enters the current workflow.

Discuss API access Review verdicts