Litigation Preparation Phase
Moving from "Dispute" to "Action." We identify the highest-ROI cases using contractual logic.
Phase 3 Overview | The Strategy Behind Litigation Authorization
Not every denied claim deserves litigation. Phase 3 is where you separate high-merit cases from weak ones, using contractual analysis and historical case outcomes to determine which disputes are worth pursuing in court.
Contractual Breach Identification
The platform analyzes payer-provider contracts to identify specific breaches—such as failure to pay within contractual timeframes or improper denial of covered services.
Merits Review & Case Scoring
Legal teams review each case for litigation merit, evaluating factors such as claim value, contractual language, and historical settlement outcomes for similar disputes.
Suit Authorization Workflow
Once a case is approved for litigation, the platform generates a master litigation file, prepares the complaint, and coordinates with external counsel for filing.
Actionable Worklists | The "How" of Phase 3
Phase 3 is where legal strategy meets operational execution. Here's how your litigation team will operate inside the platform.
Merits Review Queue – Evaluating Cases for Litigation Worthiness
Every case that fails in Phase 2 lands in the Merits Review Queue, where attorneys evaluate whether the dispute has sufficient legal merit to justify the cost of litigation.
Trigger Action:
The platform assigns a litigation score based on claim value, contractual clarity, and historical win rates for similar cases, helping attorneys prioritize high-ROI disputes.
Authorization Pending – Tracking Client Approvals and Attorney Green-Lights
Before a lawsuit is filed, the platform tracks internal approvals from clients, legal counsel, and financial stakeholders to ensure all parties are aligned on litigation strategy.
Trigger Action:
Once all approvals are secured, the platform automatically moves the case to the Master Litigation File Queue and begins complaint preparation.
Master Litigation File Queue – Building the Foundation for Court
The Master Litigation File consolidates all clinical records, correspondence, contracts, and legal analysis into a single, court-ready package for filing and discovery.
Trigger Action:
The platform generates a federal complaint using pre-approved templates and populates it with case-specific facts, breach allegations, and damages calculations.
Integrated Technology | How Phase 3 Is Powered
Contract Matrix
The platform analyzes payer-provider contracts and compares them against payer actions, identifying specific contractual breaches that can be cited in litigation.
For example, if a payer fails to respond to an appeal within 30 days as required by contract, the platform flags this as a breach and generates a litigation-ready allegation.
Workflow Phases
Before you file a lawsuit, the platform analyzes historical case data to predict the likelihood of settlement and the expected recovery amount.
Workflow Phases help you avoid pursuing cases with weak legal foundations and focus resources on disputes with the highest recovery potential.
The Transition | Moving from Phase 3 to Phase 4
A case only advances to Phase 4 (Litigation Management) when the platform confirms that all internal approvals have been secured, the complaint has been drafted, and the case is ready for filing in federal or state court.
Automatic Trigger |
Once the complaint is filed, the platform automatically moves the case to Phase 4 and begins tracking court deadlines, discovery requests, and settlement negotiations.