Eligibility Intelligence for Medicare and Medicaid roster-driven billing
Billing infrastructure for the vendors and plans operating across Medicare Advantage, Managed Medicaid, and capitated provider arrangements.
Make capitated, roster-driven healthcare billing accurate, automated, and auditable
Medicare Advantage supplemental benefits represent a rapidly growing market. Millions of seniors rely on these benefits for services ranging from meal delivery and transportation to pest control and personal emergency response systems. The vendors who deliver these services face a unique billing challenge: they must verify eligibility, calculate billable days, and generate invoices for dozens of payers, each with different file formats, enrollment rules, and retroactive adjustment policies.
Most vendors handle this with spreadsheets, manual portal checks, and institutional knowledge that lives in the heads of a few key staff members. The result is predictable: missed billable days, compliance risk, staff burnout, and revenue that falls through the cracks. The same pattern recurs in Managed Medicaid supplemental benefits and capitated provider arrangements: different counterparties, identical structural problem.
Rendum exists to solve this problem. We build Eligibility Intelligence for the entire class of capitated, roster-driven healthcare billing relationships. Our platform ingests payer files, normalizes data across formats, calculates billable days using reviewed, versioned rules that produce the same decision every time, and generates payer-specific billing recommendations with complete audit trails. We start with Medicare Advantage supplemental benefit vendors because the eligibility complexity is hardest there. The same engine extends to Managed Medicaid, capitated provider arrangements, and plan-side reconciliation.
We believe that vendors and plans serving Medicare and Medicaid beneficiaries deserve billing infrastructure that meets the False Claims Act standard. Rendum brings that infrastructure to the capitated billing space.
What we believe
Determinism Over Convenience
We choose explicit, auditable rules over black-box shortcuts. Every calculation in Rendum is reproducible and traceable. When False Claims Act exposure, Recovery Audit Contractor reviews, and state Medicaid program integrity audits are the consequence of getting it wrong, there is no room for probabilistic outputs.
Transparency by Default
Our pricing is public. Our architecture is documented. Our audit trails are complete. We believe vendors and payers deserve full visibility into how their billing is calculated, and we build accordingly.
Compliance is Not Optional
HIPAA compliance and SOC 2 readiness are not features we bolt on after launch. They are foundational requirements that inform every architectural decision, every code review, and every deployment.