Audit API
The medical-bill audit engine, as an API.
Send line items from a bill or EOB; get back the billing errors, with a plain-language explanation and an estimated recoverable amount. The same deterministic engine that powers Paxer for patients, available to your product.
Create a key in Settings → Developers after signing in.
Who it’s for
Built for the buyers whose incentives align with the patient (patient-billing platforms, TPAs, self-insured employers, and HSA/FSA admins), plus care-navigation and advocacy tools. Anywhere a bill needs an instant “is this correct?” check before someone pays it.
We don’t sell this to health plans as the primary buyer. The aligned parties are the ones who win when a bill is corrected, not when a claim is denied. See pricing →
What it detects
One call, every common billing error.
Duplicate charges
The same service billed twice on one bill or across providers.
Cost-share errors
Deductible / coinsurance / copay computed wrong against the plan.
Denials & coordination of benefits
PR-22 and other reason codes that shift a denial onto the patient.
Balance billing (NSA)
Out-of-network amounts billed above the allowed/protected rate.
Unbundling
Codes billed separately that should be a single bundled charge (NCCI).
Implausible charges
Amounts wildly out of line with what the service plausibly costs.
Request
curl -X POST https://paxer.app/api/v1/audit \
-H "Authorization: Bearer pax_live_..." \
-H "Content-Type: application/json" \
-d '{
"lineItems": [
{ "description": "Echocardiogram, complete", "cptHcpcsCode": "93306",
"chargeAmount": 980, "allowedAmount": 710, "planPaid": 0,
"patientResponsibility": 710, "adjustmentCodes": ["PR-22"] }
]
}'Response
{
"findings": [
{
"type": "NON_COVERED_BILLED_TO_PATIENT",
"severity": "HIGH",
"title": "Denial billed to you: coordination-of-benefits denial (reason code PR-22), echocardiogram",
"explanation": "Your plan allowed $710 but paid $0, and the full $710 was passed to you under a PR-22 coordination-of-benefits denial. Denials like this are frequently reversed.",
"recommendedNextStep": "Submit the primary plan's EOB to this insurer, or call to correct your coordination-of-benefits record so the claim reprocesses. Consider waiting to pay until it has been reprocessed.",
"estimatedRecovery": 710,
"confidence": 0.75,
"detector": "RULE",
"lineItemIndex": 0
}
],
"summary": {
"findingCount": 1,
"estimatedRecoverable": 710
},
"usage": {
"plan": "free",
"used": 1,
"quota": 100
}
}Errors & limits
Predictable status codes.
Quota is per calendar month and hard-capped, so over the limit returns 402, with no surprise overage charges. Usage resets on the 1st. Keys are created and revoked in Settings → Developers.
Stateless & private
Nothing you send is stored. No data is retained or shared, and responses contain only findings.
Authentication
Bearer API keys, created and revoked in Settings → Developers. Keys are shown once and stored hashed.
Limits & pricing
Free to start, rate-limited per key. For production volume or an SLA, get in touch about Enterprise pricing.