Kestrel · Claims pricing engine
Claims priced the way your contracts are written.
Kestrel prices every claim to the agreement you signed and explains every line. Fee schedules maintained for you*. Easy to configure and manage - no new staffing required.
Built for Medicare Advantage and Medicaid plans, commercial plans, TPAs and ASOs, self-funded employers, reference-based pricing programs, and health-tech builders.
* Medicare and certain Medicaid fee schedules automatically monitored and maintained.
Price it the way the contract reads.
Pick a contract. Move the slider. Watch Kestrel show its work.
Built for the problems you already have.
Config team backlogged?
We maintain fee tables for professional, inpatient, and outpatient rates so that your team doesn't have to.
Can't explain why a claim paid what it did?
Every priced line carries its own explanation. When a provider appeals or disputes, your team already has the answer.
Medicare-based contracts pricing wrong?
Kestrel prices Medicare the way CMS does: professional, inpatient, and outpatient. Fee schedules stay current, and every rate traces back to its CMS source.
Claims pending because they can't find the provider?
Kestrel matches the provider and prices the claim in one pass. Fewer claims land on someone's desk.
Negotiating without knowing what the terms will pay?
Price last quarter's claims against the new terms before you sign. See the real dollars, then negotiate.
Dreading another rip-and-replace?
Kestrel runs beside your core claims system. Your system keeps adjudicating. Kestrel matches and prices. Full REST API available to your team on day 1.
Your claims system vendor quotes 90%+ auto-adjudication. Ask them what they're counting. Then bring us a month of your claims.
See it on your claims →Fits your systems, solves your problems.
Kestrel connects to your core system through one API. Price live claims in real-time. Perform look-back analysis. Re-price capitated encounters or rental network claims for insight into costs. Analyze claims and contracts during negotiations. One license gets you full access to meet all your needs - Claims, IDRs, Med Econ, Contracting, and more.
Questions we get
Does Kestrel replace our claims system?
No. Kestrel runs beside your core system. Your system keeps adjudicating. Kestrel matches providers and prices claims.
What contracts can Kestrel price?
Professional and facility agreements: percent of billed, fee schedules, per diems, tiered fees, anesthesia, Medicare-based professional, inpatient, and outpatient, plus carve-outs and lesser-of rules. If you signed it, we can price it.
How do we know it's accurate?
Send us a contract and a sample of claims. We'll price them and walk you through every line, including where your current system got it wrong.
Do we need Dragonfly PDM?
Kestrel can price claims on its own - provide the contract you want to price against and you don't even need provider data. For claims provider matching, Dragonfly PDM is required. Dragonfly PDM and Kestrel work together to improve your provider data for both claims and directories.
How long does it take to get started?
Typical time for an enterprise implementation and integration is 60 to 90 days, depending on various factors. KestrelPricer.com launches in November 2026 and will offer same-day API access for Medicare-based pricing.
How is Kestrel priced?
Enterprise pricing is based on claim and provider volumes. The Kestrel API, launching in November 2026, has a free tier and published prices at KestrelPricer.com.
Can we try it before an enterprise deal?
Yes. The Kestrel API launches in November 2026 at kestrelpricer.com with a free tier, published prices, and an instant key.
Try it yourself. November 2026.
The Kestrel API: free tier, published prices, instant key.
Price real claims at kestrelpricer.com, then bring us your contracts.