Synthetic RCM workflow previews with the denial behavior real systems have.
Upstream Data is the synthetic healthcare data division of the Upstream Care Intelligence Platform. We build synthetic-only workflow replays, scorecards, and data packs for the engineers and teams building the next generation of healthcare AI, without touching a single real patient record.
Why we built this
Building denial prediction models requires realistic denial data. Testing RCM automation requires claims that follow plausible synthetic payer-response rules. Training prior auth systems requires authorization denial cycles that reflect public policy structures and clearly labeled synthetic assumptions.
Real patient or customer claim data creates HIPAA exposure, legal risk, and ethical problems. Upstream Data avoids that path entirely.
We solve that by synthesizing claims, documents, remits, workqueues, and replays from statistical priors and payer-behavior rule models. The patterns are source-informed and clearly labeled as synthetic assumptions. The records are entirely synthetic — no real patient ever entered the pipeline.
What makes it different
Denial behavior baked in
CARC/RARC distributions, source-informed denial patterns, prior auth denial cycles, and replay scorecards — not random noise. The behavior is structurally plausible across specialties without claiming observed payer fact.
Zero PHI. Architectural guarantee.
No real patient data enters the synthesis pipeline. The guarantee is contractual and architectural — not a policy. Statistical priors + rule models only.
Specialty-specific, not generic
37 previewable commercial packs across 5 care settings: behavioral health, facility, home health, outpatient, and dental. Each pack reflects specialty-specific denial, authorization, payment, and document behavior.
The team
Upstream Data is built by the same team behind the Upstream Care Intelligence Platform — healthcare payer risk intelligence for providers. We detect payer behavior changes 38 days before traditional reporting surfaces them. That domain expertise informs every denial distribution in every data pack.
We're based in Dallas, TX. data@upstream.cx
Start building with synthetic claims
Browse 37 packs across 5 care settings. Buy by pack, or start with a free 1K-row sample. Delivered by signed link, zero PHI, synthetic-only attestation in every bundle.