Care Intelligence Platform for healthcare providers.
The Line: Upstream turns payer behavior into operator-ready care actions.
Upstream reads payer behavior at the source, briefs the operator on what it means, and proposes a tested action they approve in one click. Detection, brief, action, approval, execution, and outcome run as one closed loop.
| Surface | Audience | Where |
|---|---|---|
| Care Intelligence Platform | Healthcare specialty practices and their billing / RCM operators | upstream.cx |
| Synthetic claims marketplace | AI/ML engineers, RCM tooling builders, prior-auth automation teams | data.upstream.cx |
| Free intelligence tools | Operators, analysts | upstream.cx/tools |
| Payer Behavior Index | Public OSS dataset | Hugging Face Space |
| Prior Auth Sandbox | OSS devtool | Hugging Face Space |
| Plan Denial Heatmap | Public OSS dataset | Hugging Face Space |
upstream-mcp— Upstream MCP server, exposing Care Intelligence as Model Context Protocol toolsupstream-skills— reusable Claude / agent skills for healthcare workflowsupstream-community— discussions, ideas, and operator-led knowledgeawesome-payer-risk— curated list of payer behavior tracking, denial intelligence, and care ops tooling
The core platform repo and the synthetic data SDK are private at this time.
Care decisions flow downstream from payer behavior. Most denial tooling reacts after the EOB lands. Upstream sits above that flow, reads payer patterns at the source, and turns them into operator-ready care actions.
For builders shipping AI tools or RCM workflows, the synthetic claims marketplace at data.upstream.cx provides realistic denial behavior without PHI.
- Operators and beta interest: hello@upstream.cx
- Developer API: hello@upstream.cx
- Builder collaborations: hello@upstream.cx
- Sales and partnerships: kevin.richards@upstream.cx