Pick how much of the prepared flow we run.
Four ways to buy, one platform. The platform does not change between them. What changes is how much of the prepared work your team runs, how much Upstream runs with you, and whether you pay a flat base or only per submission.
What changes from one tier to the next?
The platform stays the same. The difference is how much of the prepared specialty care flow Upstream runs with your team, and how much still stays manual inside the practice.
Assist
Best when the team needs earlier signal, clearer requirements, and a steadier benefits and prior-auth path without changing who still runs the work.
Pay as you go
Best when volume is low or uneven and the team wants prepared actions without a monthly base, paying a flat fee only on the submissions Upstream prepares.
Co-pilot
Best when the team wants prepared actions and a tighter denial-management loop at steady volume, while still approving every move and keeping control in house.
Autopilot
Best when the practice wants Upstream to run the prepared flow closely with them and keep the operational picture clear for leadership.
Pricing tiers
Assist
Smarter than a coordinator.
per location, per month
- Early payer intelligence on the rule changes that hit your procedures.
- Coverage, benefits and eligibility, checked before the requirements stack up.
- Prior authorization requirements confirmed before you submit.
- Briefs in plain language, ranked by what is at risk.
- Flat price per location, no per-submission fees.
Pay as you go
Only pay when you submit.
per submission, no monthly base
- Everything in Co-pilot: prepared appeals, submissions, and verifications.
- No monthly base. A flat fee only on the submissions the platform prepares.
- Read-only portal steps when you delegate portal access, under your approval.
- Best for low or uneven volume, or starting without a commitment.
Co-pilot
80% automated. 100% yours to approve.
per month, plus per submission
- Everything in Assist.
- Prepared actions: appeals, submissions, verifications.
- Read-only portal steps when you delegate portal access, under your approval.
- Clear revenue intelligence by payer and procedure.
- Lower per-submission fee than Pay as you go once volume is steady.
Autopilot
We run the prepared flow with you.
retainer, contact sales
- Everything in Co-pilot.
- We staff and run the specialty care operations flow end to end.
- A named team and a service level you set.
- Reporting your finance lead can take to the board.
Prices shown are starting points. Final pricing depends on locations and submission volume.
Founding Cohort
We are taking on a small group of early practices at design-partner pricing, in exchange for case studies and feedback that shape the product. You help us refine the operating path in a live environment. We work closely and price it accordingly.
Bring a recent case. No commitment.
Bring a recent case or batch. We will show what the payer was actually checking, the work we would prepare, and where Upstream keeps the next step clearer across the full care intelligence path before you decide anything.
Pricing, answered plainly.
- What does the recent case review include?
- We review a recent case or batch from your workflow and show what we would have flagged and what we would have prepared. It is a starting point, not a tier, and there is no commitment.
- How is Co-pilot priced?
- Co-pilot is a flat base from $1,500 per month plus a fee per prepared submission. You only pay the per-submission portion on the work the platform actually prepares for your approval.
- How is Pay as you go different from Co-pilot?
- Same prepared work, same approvals. Pay as you go has no monthly base and a higher flat fee per prepared submission, so it fits low or uneven volume and starting without a commitment. Co-pilot adds a monthly base and a lower per-submission fee, which works out cheaper once volume is steady. Neither is ever a percentage of recovered dollars.
- What is the Founding Cohort?
- The Founding Cohort is design-partner pricing for the first practices we work with, offered in exchange for case studies and feedback. The published ladder is the standard price.
- Will this replace my team?
- No. It gives your team more room to work well. People approve every action; the platform handles the preparation and repetitive denial-management work around it.
- Is our patient data safe?
- Protected health information stays encrypted and scoped to your practice. Every action waits for a human approval. We are HIPAA-aligned with the controls in place.
Bring one recent case.
We will walk through how Upstream reads the payer context, prepares the work, and keeps the next step clear. No commitment.