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📡 Upstream

Early-warning intelligence for healthcare revenue operations.

What Upstream Does

Upstream is an early-warning intelligence system for healthcare revenue operations. It detects when payers change their behavior—denying more claims, changing policies, or creating new revenue risks—usually 30-60 days before traditional monthly reporting would catch it.

For Operators: Think of Upstream as a smoke detector for your revenue cycle. It doesn't fight the fire for you, but it tells you early when something's wrong so you can act before it becomes expensive.

Core Features

  • 📊 DriftWatch (Denial Rate Detection) — Detects week-over-week changes in payer denial rates. Catches when a payer who normally denies 8% suddenly denies 15%.
  • 💰 DenialScope (Dollar Spike Detection) — Flags sudden increases in denial dollars by payer or reason code. Identifies $50K+ revenue leaks before they compound.
  • 📁 Claim Upload & Normalization — CSV upload with automatic payer name and CPT code mapping. Works with your existing data.
  • ⚠️ Smart Alerting — Statistical thresholds flag significant changes, not noise. Email alerts with evidence and context.
  • 📈 Weekly Analysis — Runs automatically. You get early signals, not month-end surprises.

Who Should Use Upstream

Primary Users:

  • Revenue Cycle Directors who need early visibility into payer behavior changes
  • Billing Managers tracking denial trends and payer policy shifts
  • RCM Analysts investigating root causes of revenue variance

What You'll See:

  • Alerts when payers change denial behavior outside normal variance
  • Evidence tables showing which claims, payers, and codes are affected
  • Historical context to distinguish new issues from recurring patterns
  • Actionable signals, not raw data dumps

Time to Value:

  • Setup: 30 minutes (upload claims, configure alerts)
  • First insight: After first weekly run (~5 days)
  • Routine use: 5-minute daily check, 20-minute weekly review

Read more: See OPERATOR_GUIDE.md for detailed workflows and decision frameworks.

Tech Stack

Layer Technology Why
Backend Python 3.12, Django 5.x Rapid iteration, batteries included
API Django REST Framework Industry standard, JWT auth ready
Database SQLite (dev), PostgreSQL (prod) Simple dev, scalable prod
Security django-auditlog, encrypted fields PHI compliance ready
Frontend Django Templates → React (planned) Server-first, SPA later

Getting Started

Quick Start

# Install dependencies
pip install -r requirements.txt

# Apply database migrations
python manage.py migrate

# Load demo data (optional - creates sample practice)
python manage.py loaddata demo_data

# Create a superuser
python manage.py createsuperuser

# Run the development server
python manage.py runserver

Visit http://localhost:8000 to access the application.

Running Payer Drift Analysis

# Run weekly payer drift detection for all customers
python manage.py run_weekly_payer_drift

API Access

# Get JWT token
curl -X POST http://localhost:8000/api/v1/auth/token/ \
  -H "Content-Type: application/json" \
  -d '{"username": "your-user", "password": "your-pass"}'

# View API documentation
open http://localhost:8000/api/v1/docs/

Project Structure

upstream/
├── models.py              # Customer, ClaimRecord, DriftEvent, etc.
├── views.py               # Web portal views
├── api/
│   ├── serializers.py     # DRF serializers
│   ├── views.py           # API viewsets
│   ├── permissions.py     # Multi-tenant access control
│   └── urls.py            # API routes
├── services/
│   └── payer_drift.py     # Core drift detection algorithm
├── management/commands/   # CLI commands for scheduled tasks
├── fixtures/              # Demo data for onboarding
└── templates/             # Django HTML templates

Roadmap

Phase 1: Core Platform ✅

Multi-tenant architecture, CSV uploads, payer drift detection, API layer

Phase 2: Enhanced Analytics

Trend visualization, custom date ranges, CPT group-level drift, payer benchmarking

Phase 3: Enterprise

SSO/SAML, role-based access, webhook integrations, audit logging dashboard


Contributing

This project is in active development. See CHANGELOG.md for recent updates.

Questions? Contact the team at scale@getbyteworthy.com


License

Proprietary — © 2026 Byteworthy. All rights reserved.

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