Why AI built by clinicians who’ve walked in your shoes outperforms tech startups learning on the job
HAMDEN, CT / ACCESS Newswire / January 22, 2026 / Not all AI in home health and hospice is created equal. Many AI solutions appear similar at first glance. They promise efficiency and reduced administrative burden. What separates them is the depth of industry knowledge behind the technology. That distinction matters.
In other words, there is a big difference between a healthcare company creating technology and a tech company breaking into the healthcare industry. People matter in home health and hospice. That includes the people who make the tools you use.
SimiTree is a tech-enabled healthcare services company that uses AI and automation to make agencies stronger. Its clinical solution, SARA, is trained on more than one million home health and hospice charts, while its financial solution, CLARITY, delivers 90% forecast accuracy. Together, these solutions bring data-driven intelligence, transparency, and human expertise to every stage of the care and revenue cycle.
Tech startups learning healthcare will try to reverse-engineer their way into the field. They see coding, OASIS review, and revenue cycle management as technical puzzles to solve, not as clinical and financial lifelines that must function correctly every day. That gap leads to blind spots that only become visible through trial and error.
For example, some AI systems train on hospital data, then misapply acute care codes that have nothing to do with home health or hospice. When a system suggests a hospital-appropriate diagnosis code for a home health episode, the consequences cascade: denied claims can delay reimbursement by 30 to 60 days, triggering cash flow problems that force agencies to delay hiring or cut services. Audit requests consume staff hours that should be spent on patient care. Repeated errors damage payer relationships and increase scrutiny on future claims.
SimiTree starts from a different place. We built our solutions with decades of hands-on experience in coding, OASIS, and financial management for home health and hospice agencies. We’ve walked in your shoes – we are clinicians and healthcare experts who understand how agencies work and where accuracy matters most.
Built by clinicians, for clinicians
SARA, SimiTree’s clinical assessment review AI, was created by clinicians who intimately understand the documentation challenges agencies face every day. Trained on more than one million anonymized home health and hospice charts, SARA has a command of documentation patterns and coding practices that general-purpose AI systems simply cannot match.
SARA knows which documents count in home health and hospice-and which ones to ignore. It was designed specifically for PDGM accuracy, payer compliance, and coding efficiency. It reads, learns, and highlights the sections of documentation that matter, but human coders remain central to every review.
The same philosophy drives the creation of CLARITY, our analytics platform for revenue cycle management. Our reimbursement and RCM specialists took part in the design of CLARITY, because they have experienced the daily challenges of billing, collections, and compliance in post-acute care. It is this perspective that lets us answer the question, “What do agencies need to know, but struggle to see organized in a single, easy-to-access way?”
Putting clinicians first means keeping human expertise at the center. AI is there to make skilled people faster, never to replace them. Accuracy depends on judgment, context, and accountability. A clinician knows that machines cannot supply these qualities on their own.
Safety and human expertise
Accurate coding is tied directly to reimbursement and compliance. A single mistake can reduce margin or trigger repayment requests. The most reliable safeguard is the combination of AI and human validation.
SARA uses a human-in-the-loop model. Coders confirm AI suggestions, sequence codes according to established guidelines, and apply payer-specific rules that vary across markets. This ensures that each recommendation is accurate, compliant, and ready for review.
Wound care shows why this balance matters. Many home health patients have wounds that must be assessed and documented through photos. AI cannot interpret those images or assess the clinical nuances of wound severity and healing. Without a trained human to verify and code that information, agencies risk errors, denials, and compliance problems.
Similarly, CLARITY automates data aggregation and prediction, but human revenue cycle specialists analyze the patterns behind denials and payment delays. They apply their knowledge of payer behavior, compliance rules, and operational workflows to turn raw analytics into concrete next steps.
Transparency and trust
Clinicians and leaders want to know why a tool makes a recommendation, not simply that it does.
SARA delivers transparency by showing every AI-generated suggestion alongside its source in the chart. The system highlights exactly where a candidate’s diagnosis appears and identifies whether it represents a current or resolved condition. Coders can also see if a suggestion originates from a non-permissible document and exclude it immediately.
The same philosophy drives CLARITY. We built CLARITY to provide real-time insight into financial performance and cash flow using data pulled from multiple EMRs, clearinghouses, and SimiTree’s own tools. The platform aggregates 10 to 15 daily reports per client, connects to two major clearinghouses updated every 12 hours, and integrates proprietary systems like Arbor and Notify.
The platform uses predictive models to forecast billing, cash, and revenue goals based on census, admissions, and historical data. It projects agency performance 90 days in advance with accuracy approaching 90 percent. These forecasts help leaders identify seasonality, growth patterns, and emerging issues before they become problems.
Automation that serves people
CLARITY brings the same clinician-first philosophy that shaped SARA to the financial side of the business. Our aim is to empower agencies to make faster, better-informed decisions about billing, collections, and cash management.
Every data point in CLARITY is interactive. Users can drill from a high-level summary down to individual claims, sort by payer, or isolate Medicare versus non-Medicare performance. Clients can track their Days Sales Outstanding (DSO) and denial rates at the payer level, identify the reasons for unpaid claims, and monitor the actions taken to resolve them.
Daily emails automatically summarize progress toward cash and billing goals, outstanding denials, and unbilled accounts. Agency leaders wake up each morning with an at-a-glance view of performance and clear steps for action.
The result is more accountability and more transparency between SimiTree and its clients. Every note and update entered by SimiTree staff is visible and exportable. Clients always know what is happening with their claims.
How to evaluate AI for home health and hospice
At a high level, the people who make your tools matter as much as the solutions themselves. Their expertise and intentions matter. The “move fast and break things” ethos of would-be tech industry disrupters doesn’t work when it comes to the human judgment necessary for home, health, and hospice organizations to grow and continue serving patients.
For leaders considering AI tools, here is a simple checklist that separates clinician-built solutions from generic automation:
Look at the founders. How strongly is the team rooted in healthcare solutions? Do they have extensive backgrounds in home, health and hospice? Or are they Silicon Valley alums playing catch-up?
Transparency matters. Can it show you the exact chart citation behind every suggestion, including whether a condition is current or resolved?
Humans in the loop. Are there layers of human oversight and payer-specific configurations to prevent denials and ADRs?
Drag and drop implementation. Will it fit your EMR and workflow with minimal IT lift and change management?
If the answer is no to any of these, the risk is too high.
Clinicians built SARA. Real people with decades of home, health, and hospice experience support and validate our AI solutions. Your success is our mission.
If you would like to know more about what sets us apart, please request a demo or reach out to us. We’re eager to show you how we can drive accuracy and better outcomes in your work.
About SimiTree
SimiTree, a Sheridan Capital Partners portfolio company, is a leading provider of tech-enabled specialty revenue cycle management, coding, consulting, staffing solutions, and managed services for home health, hospice, and behavioral health organizations. By combining deep domain expertise with innovative technology, SimiTree helps providers optimize operations, ensure compliance, and achieve sustainable growth. For more information, visit http://www.simitreehc.com
Contact Information
Company Name: SimiTree
Contact Name: Meredith Carroll
Phone Number: (800) 949-0388
Email Address: [email protected]
Website Link(s): http://www.simitreehc.com
SOURCE: SimiTree
