AI-powered reimbursement capture and recovery for skilled nursing

You took care of the patient.
We make sure you get paid for it.

Foster continuously reads the patient chart to surface missed reimbursement before the ARD closes, catch claim errors before submission, and prepare denial evidence automatically.

Request your free audit
20hrs
saved per MDS team per building per week
85%
faster ADR turnaround
3–8×
ROI within 6 months
Read-only setup
No workflow changes
Evidence-backed recommendations
The problem

The money is already there. It just isn't being collected.

A patient's chart has the diagnosis, wound care, therapy, and documentation to support the right reimbursement. But no one has time to catch every driver before the MDS closes or the claim goes out. So the facility gets paid less than it earned.

Many SNFs lose $400K+ a year this way. Not from bad care. Not from fraud. From a reimbursement process complex enough to leak revenue at every step.

Example Medicare paid $380/day. The correct rate was $520/day. The documentation was in the chart. The window just closed before anyone caught it.
$400K+
average annual reimbursement leakage identified per SNF — from missed drivers, coding gaps, and unchallenged denials.
Identified by Foster's AI across retrospective Medicare diagnostics.

Clinical AI that works the full revenue cycle.
From the first chart read to the last appeal.

01
Connect
Foster sits directly on top of your existing EHR as a Chrome extension — no new system for your team to learn, no workflow changes, no IT project. Connect PointClickCare, MatrixCare, or NetHealth in minutes with read-only access.
02
Recommend
Foster reads every document continuously — admission records, progress notes, therapy logs, hospital records — and flags what's billable with the evidence already attached. It detects IPA triggers, handles physician querying end to end, reviews the MDS for coding errors, and surfaces inaccurate assessments before the ARD closes.Foster scans the chart, flags billable items with proof attached, catches IPA triggers and MDS errors, and surfaces issues before the ARD closes.
03
Prevent denials
Before every claim goes out, Foster runs an automated UB-04 triple-check — validating HIPPS codes, ARD timing, diagnosis codes, PDPM categories, and billing fields. Errors caught pre-submission, not post-denial.
04
Appeal & recover
When a denial or ADR lands, Foster assembles the complete response packet automatically — denial letter analysis, AI-matched clinical evidence, and a defensible appeal narrative. Weeks of prep compressed to hours.
Foster Clinical AI Engine · Data ingestion
Connecting
PointClickCare
MatrixCare
NetHealth
3rd Party Provider Data
Foster Clinical AI Engine
Works as a Chrome extension · sits on top of your EHR · no new system to learn
AI MDS Copilot · Active worklist
3 findings
Margaret Sullivan · Room 204A · Day 5 · ARD locks in 5 days
Physician query required
Chronic respiratory failure with hypoxia — not coded (J96.11)
Resident has documented COPD with long-term O2 use. Nursing notes document desaturation on room air and SOB laying flat. Chronic respiratory failure with hypoxia qualifies as NTA comorbidity — not currently coded in MDS.
Query drafted · sent to Dr. Patel via PCC · 08:42 AM
Response received · J96.11 confirmed · 10:15 AM
MDS update pending coordinator review
IPA trigger detected
Diet change + swallowing disorder — COC not completed
PM shift changed diet due to noted pocketing. No e-INTERACT COC completed. Episode not communicated in communication book. SLP swallowing disorder and mechanically altered diet not identified in MDS — flagged 5 days after qualifying event.
Inaccurate assessment
PHQ-9 = 0 but nursing documentation contradicts
PHQ-9 scored 0 in MDS. Nursing progress note same date: "resident crying, verbalizing feeling helpless, referred to psych." Mood assessment inconsistent with clinical documentation — depression not coded.
UB-04 Validation · CLM-4821 · James Wilson
1 flag
ARD & Occurrence Code 50
Passed
HIPPS Code Validation
Passed
Admit Date Consistency
Passed
Type of Bill (TOB)
Passed
!
Section GG · Functional Score
MDS: substantial assist · PT notes: supervision only
Flagged
PDPM Categories
Passed
Diagnosis Codes
Passed
Daily Skilled Coverage
Passed
Certification Dates
Passed
ADR Response Generator · CLM-4821 · Medicare
Ready
Denial letter
Parsed & analyzed
AI analysis
Evidence matched
Clinical defense
Packet assembled
Clinical evidence assembled
Physician certification signed 01/06 · Skilled need documented
MDS ARD 01/10 · HIPPS RVA01 · PT minutes 480 · SLP 240
Daily skilled nursing notes 01/06–01/20 · Wound care documented
Defense packet ready · Estimated response time: under 2 hours

Know exactly what Foster is capturing.
Per patient. Per recommendation.

Every PDPM uplift, billing correction, and denial recovery is attributed to the exact chart finding that produced it — and flows directly to your bottom line. Fixed cost base means every dollar captured is EBITDA.

Expert-built
Developed alongside senior MDS nurses and validated against the RAI Manual. Every recommendation reflects 20+ years of SNF coding expertise — not a generic LLM.
AI you can trust
Every recommendation deep-links to the exact source note in PCC. Your coordinator sees the clinical evidence before accepting anything. High-confidence cases move to action; borderline cases go to review.
Read-only setup
Foster never writes to your EHR. Read-only PCC access, BAA executed before day one, no IT project, no workflow changes. Up and running in days.
High flow-through to EBITDA
Most SNF costs are already in place. When MDS accuracy improves and reimbursement increases on existing residents, much of that uplift can flow through to operating income with limited incremental overhead.
Revenue impact

Average additional revenue
per building, per year.

$0
Additional revenue
Before Foster
$100K–$120K
Additional revenue
With Foster
Based on Foster retrospective diagnostics · Medicare FFS patients · results vary by facility

Things operators
always ask us.

Is Foster just another MDS tool?

No. MDS tools help coordinators complete assessments. Foster reads the chart first — surfacing what should be in the assessment before it's coded, then follows the claim downstream through billing and denial defense. The MDS is the starting point, not the whole product.

Will this add more work for my MDS coordinators?

The opposite. Foster replaces hours of manual chart hunting with a prioritized worklist — each finding linked directly to the source note in PCC. Your coordinators spend less time digging and more time on the judgment calls that require clinical expertise.

Will better coding lead to more ADRs and audits?

ADRs happen when billing doesn't match documentation. Foster only surfaces drivers already supported in the chart — every recommendation includes the clinical evidence attached. That alignment reduces audit risk. And if an ADR does come, the response packet is assembled automatically from the same chart evidence Foster already pulled.

How does Foster access our patient data?

Read-only. Foster connects to PointClickCare via a read-only integration — we never write to your EHR or alter any records. Setup requires no IT project and no PCC replacement. We execute a BAA before accessing any patient data and comply fully with HIPAA requirements.

How do we know the recommendations are accurate?

Foster's clinical AI is built on the RAI Manual and trained alongside experienced MDS nurses — every recommendation includes a direct deep-link to the exact source note in PCC that supports it. The physician order, therapy doc, or nursing entry is right there. Your coordinator verifies in one click before accepting anything. Nothing is a black box.

How do you avoid false positives in your recommendations?

Foster doesn't treat every documentation gap as a billable opportunity. Every recommendation runs through clinical validation against the RAI Manual, cross-referencing the full chart before anything surfaces to your team. High-confidence cases move to action; borderline cases go to review — with the supporting evidence already assembled so your coordinator makes the call, not the AI. Nothing is auto-submitted.

How long does it take to see results?

The free diagnostic produces findings within days of read-only access being granted. Once live, Foster surfaces missed drivers on active admissions immediately. Most facilities see their first attributable recovery within the first billing cycle.

See what your facility is leaving on the table.

Start with a free retrospective audit — 20 Medicare patients, read-only access, full findings report. You see the number before you commit to anything.