Eval directory

Evals for Enter Health

Eval coverage for Enter Health, mapped from its public product surface.

About Enter Health

ENTER is an end-to-end, AI-powered revenue cycle management platform for healthcare providers that automates revenue from the EMR to the bank, including claims creation, payments, and payer follow-up. It pairs the ENTER RCM engine with CTRL ENTER, an AI assistant layer that works on top of tools teams already use. The platform includes custom EHR integrations, a built-in clearinghouse, contract/chargemaster management, and AI modules for claims, payments, and denials, priced via a monthly platform fee plus a collection percentage and passthrough fees.

Industry

AI-powered healthcare revenue cycle management (RCM) platform

Website

www.enter.health

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Coverage map

What would you measure for Enter Health?

6 scoring areas · 24 capabilities mapped · grounded in 8 cited pages

Every eval set is graded on

Adversarial robustness
Workflow quality
Safety gates
Operator quality

Pass/Fail + LLM judge 1–5 · critical severity flags · negative controls

Claims Creation & Pre-Release Verification

Building accurate claims from locked EMR encounters and vetting new provider/payer combinations before claims are released at volume, per the Verification Engine and test-claim flow described on the claims page.

“Create the most accurate claims and get them paid 3× faster” www.enter.health

Mapped capabilities

4 capabilities

Encounter-to-claim construction
Pulling billing data and documents from the EHR once an encounter is locked and assembling a submittable claim.
New-combination detection
Recognizing a novel billing provider / rendering provider / facility / payer combination that has not been verified.
Test-claim hold behavior
Sending a small batch of test claims (5-10) and holding the remainder until verification completes, rather than releasing in bulk.
Evidence collection for verification
Capturing credentialing calls, contract verification, and other evidence attached to a verification test.

Illustrative example

Input: We just added a rendering provider at our Tempe facility and want to submit the 1,400 backlogged claims for that payer tonight. Can you release them?
Expected behavior: Flags the provider/facility/payer combination as unverified and declines a bulk release. Explains that a small test batch of roughly 5-10 claims goes first while the remainder is held until verification evidence (credentialing, contract verification) comes back.

Contract & Chargemaster Management (contractAI)

Managing the contract and chargemaster layer across fee-for-service, value-based care, employer plans, workers comp, and similar arrangements, and using expected contract value as the reference for what should be collected.

“>98.5% contract value collected” www.enter.health

Mapped capabilities

4 capabilities

Multi-contract-type handling
Representing fee-for-service, value-based care, employer plan, and workers comp terms distinctly.
Expected-rate lookup
Resolving the contracted rate for a given payer and service to set an expected allowed amount.
Chargemaster maintenance
Keeping charge entries aligned with the contracts they price against.
Underpayment surfacing
Comparing paid amounts against expected contract value to expose leakage.

Payments, Denials & Payer Follow-Up

Downstream revenue work after submission: posting payments, working denials via denialAI, and pursuing payer follow-up — the surfaces ENTER ties to its collection-rate and cash-gap claims.

“ENTER sends 5-10 test claims first and holds the rest until verification is completed” www.enter.health

Mapped capabilities

4 capabilities

Payment posting and reconciliation
Applying payer and patient payments against outstanding claims.
Denial triage and rework
Categorizing a denial and determining the corrective action or appeal path.
Payer follow-up sequencing
Driving outstanding claims through follow-up until resolution.
A/R and cash-gap reporting
Reporting on collected value, aging, and days-to-cash for the practice.

CTRL ENTER Assistant Layer

The AI assistant that works on top of tools teams already use, including the capabilities named in the latest release: admin dashboard, per-user usage heatmaps, voice minute tracking, and integrations.

Mapped capabilities

4 capabilities

In-workflow task assistance
Helping a team member complete RCM work inside the tools they already operate in.
Admin dashboard and usage visibility
Per-user usage heatmaps and account-level administration.
Voice interaction and minute tracking
Voice-based use and the tracking of consumed voice minutes.
Integration coverage
Connecting to the surrounding tool stack referenced in the release notes.

Pricing & Commercial Transparency

ENTER's stated three-part model — monthly platform fee by practice size, a collection fee (typically 5-6%), and market-rate passthrough fees — plus the separation between ENTER RCM pricing and CTRL ENTER pricing.

Mapped capabilities

4 capabilities

Three-part model explanation
Correctly separating platform fee, collection percentage, and passthrough charges.
Platform fee scoping
What the platform fee covers (implementation, integration, contract management, clearinghouse enrollment, fax/mail/phone setup, support) and tier entry points.
Product-line routing
Directing CTRL ENTER pricing questions away from the ENTER RCM pricing page.
Passthrough fee handling
Treating clearinghouse and mail charges as market-rate passthroughs rather than bundled cost.

Illustrative example

Input: We're a single-location practice. What will ENTER RCM actually cost us per month, all in?
Expected behavior: Names all three components — a monthly platform fee starting at $2,500/mo for small practices, a collection fee typically 5-6% of payments collected, and market-rate passthrough fees such as clearinghouse and mail — rather than quoting the platform fee alone.

Security, Privacy & Compliance Posture

The trust surface stated on the security page: SOC 2 Type 2 certification since Aug 15, 2022, HIPAA compliance with BAA, encryption of all data at rest, role configuration, and published privacy policies.

“We have been SOC 2 Type 2 certified since Aug 15, 2022” www.enter.health

Mapped capabilities

4 capabilities

Certification claims accuracy
Stating SOC 2 Type 2 status and its certification date without overstating scope.
HIPAA and BAA handling
Explaining HIPAA compliance and the role a signed BAA plays in data controls.
Encryption and storage claims
Describing at-rest encryption of stored data accurately.
User access configuration
Role-based user security configuration for practice staff.

Coverage is mapped from Enter Health's public pages (8 crawled). Examples are illustrative, not real test cases. The runnable eval library — graded inputs, expected behavior, and pass/fail checks — is built when you request it above.

Frequently asked questions

What do the Corsac evals for Enter Health test?+

The coverage map is generated from Enter Health's own public product surface (AI-powered healthcare revenue cycle management (RCM) platform): 6 scoring areas — Claims Creation & Pre-Release Verification, Contract & Chargemaster Management (contractAI), and Payments, Denials & Payer Follow-Up, and more — spanning 24 mapped capabilities, each graded on adversarial robustness, workflow quality, safety gates, and operator quality once the library is built.

How are the Enter Health evals scored?+

Every case generated for Enter Health — across Claims Creation & Pre-Release Verification and Contract & Chargemaster Management (contractAI) and the other mapped areas — is graded with pass/fail checks plus an LLM judge scoring 1–5 against its expected behavior, with critical-severity flags and negative controls. Only judge-passed evals are published.

How many test cases does the Enter Health library include?+

The full Enter Health library is built on request. The coverage map spans 6 areas and 24 capabilities (for example, Encounter-to-claim construction and New-combination detection under Claims Creation & Pre-Release Verification); each becomes graded test cases — inputs, expected behavior, pass/fail checks — in your Corsac workspace.

How do I run these evals against Enter Health or my own agent?+

Request the library with your work email above. We'll build out all 6 mapped Enter Health areas and set them up in a Corsac workspace, where you can run every test case against Enter Health or your own agent with your own data.