Every year, $450 billion moves through Medicare Part B. The infrastructure adjudicating those payments — TriZetto Facets, QNXT, legacy mainframes — was built in the late 1990s. It was never designed for the financial precision that PE diligence, MA plan auditing, or real-time pre-adjudication requires.
CAPE is what happens when you encode the problem correctly from the start. 247 rules from 42 CFR Part 414, implemented as deterministic mathematical functions. Phase 0 through Phase 7, every modifier, every GPCI adjustment, every multiple-procedure reduction — mathematically tied to the statutory language. No approximations. No black boxes.
We built this because the market was telling us something important: the companies that need to make precise financial decisions about healthcare — private equity firms buying physician practices, MA plans auditing their claim histories, clearinghouses building the next generation of RCM infrastructure — had no way to get a mathematically defensible answer. We built the engine that gives them one.