OPEN SOURCE
Care Intelligence for the full payer lifecycle. Built in public.
Three layers. The Care Intelligence Platform is a paid SaaS. The Upstream API and the MCP server are paid products with MIT-licensed open clients. The Skills, ML methodology, curated payer risk list, and public demos are pure OSS: everything that helps the broader RCM community audit the approach.
GITHUB
Four repositories
One MCP server, one skill pack, one ML methodology reference, one curated reading list. Each repo cross-links the others.
PUBLIC DEMOS
Three live tools
Interactive dashboards and scoring tools. No signup. Public demos show methodology and aggregate signal context, not paid-depth data products or customer claims.
Payer Behavior Index
Weekly public payer-friction signal
Public-safe weekly payer-friction dashboard built from public references and aggregate methodology. No customer claims and no payer-truth claims.
Plan Denial Heatmap
Interactive denial-rate visualization
Heatmap of denial rates by payer plan and specialty. Spot the worst plan-specialty pairings in your book before signing the contract.
Prior Auth Sandbox
Pre-submission PA approval scoring
Score a prior authorization request from 0 to 100 before submission. Returns risk factors and fix instructions. Powered by the same model behind the upstream-mcp `check_prior_auth_readiness` tool.
THREE LAYERS
Paid product, paid product with open clients, pure OSS.
The platform is a paid SaaS. The API and MCP are paid products; the client code is MIT and free to fork, but production calls require a paid key. The remaining components are pure OSS for the community to audit and contribute to.
| Layer | What it is | License / access |
|---|---|---|
| Care Intelligence Platform (SaaS) | The full operator app at app.upstream.cx. Pioneer beta + Pro tiers. | Paid subscription |
| Upstream API + MCP server | Paid product with MIT-licensed clients (upstream-mcp, CLI, SDK samples). Embed the intelligence into your own systems. | MIT client + paid backend. Workflow / Org / Enterprise. Free eval tier: 500 calls/month. |
| Skills, methodology, curated list, HF Spaces | Everything below the paid layer that helps the RCM community learn, audit, and contribute. | Public/open artifacts only. License terms vary by artifact and paid-depth data products stay gated. |
What stays private
Production model weights, tuned thresholds per payer and specialty, live 835 ingestion, the operator network signal, and customer-scoped tenant data stay inside the platform. The methodology is open; the production application is not.
CONTRIBUTE
Open a PR
All four GitHub repos accept contributions. In scope: additional CARC/RARC entries, improved feature engineering, additional specialty templates, notebooks demonstrating reference implementations on public datasets, documentation, bug fixes, and additions to the curated list. Out of scope: anything requiring proprietary payer data or production internals.
Free Claim Audit
The platform reads payer behavior. The OSS shows how.
The Care Intelligence Platform itself is a paid product. Pioneer beta is $49/mo locked for life. The open source is for the community to audit, learn from, and contribute to.