For WISeR participants
The licensed clinician
behind every non-affirmation.
Your platform screens the request. CMS requires that a human clinician with relevant clinical expertise review every non-affirmation, and that no denial be made solely by technology. Next: a specialty-matched reviewer, named on the record, and a hash-anchored receipt your auditor can check without you. today: the sandbox runs synthetic samples in your browser.
Pre-go-live pilot. Sandbox for synthetic or de-identified requests; a BAA before any patient data.
The requirement, in CMS's words.
“All recommendations for non-payment are determined by appropriately licensed clinicians who will apply standardized, transparent and evidence-based procedures to their review.”
WISeR model page →“A human clinician with relevant clinical expertise for selected items and services must review every non-affirmation.”
WISeR FAQ →“Non-affirmations will require the review of a human clinician and cannot be performed solely by technology.”
WISeR FAQ →What we are building to supply
- Relevant clinical expertise. Designed so that reviewers are matched to the item or service — skin substitutes, nerve stimulators, knee arthroscopy — and verified against the CMS NPPES registry, and so that outside a covered specialty the gate fails closed and says so. Today: the sandbox runs synthetic samples.
- A named human on every non-affirmation. Next: affirm, revise, or decline with a documented rationale; today: the sandbox runs synthetic samples in your browser.
- A receipt for the audit. NPI display, timestamp, document hash, and signature, verifiable at harnesshealth.ai/verify/<id>. CMS audits participant determinations; this is designed to be the record that survives one without your cooperation. Today: the only signer is a demonstration key.
- Capacity you do not have to hire. Volume arrives in waves and by specialty. Designed so that review capacity follows the volume, not a bench you hire.
The six participants
January 1, 2026 through December 31, 2031. Source: CMS.
| Cohere Health | Texas | JH Novitas |
| Genzeon | New Jersey | JL Novitas |
| Humata Health | Oklahoma | JH Novitas |
| Innovaccer | Ohio | J15 CGS |
| Virtix Health | Washington | JF Noridian |
| Zyter | TruCare | Arizona | JF Noridian |
Listed as published by CMS. Not an endorsement by or of any participant. Model page.
Straight answers
What exactly does CMS require of a WISeR participant on a denial?
CMS states that all recommendations for non-payment are determined by appropriately licensed clinicians, that a human clinician with relevant clinical expertise must review every non-affirmation, and that non-affirmations cannot be performed solely by technology. CMS also says participants will typically issue a determination within three days of receiving a request, and within two days for an expedited one.
CMS WISeR FAQ →Can HarnessHealth be that clinician?
That is the design: specialty-matched, registry-checked physicians who review, sign, revise, or decline with a documented rationale, plus the receipt. Next: a specialty-matched reviewer, named on the record; today: the sandbox runs synthetic samples in your browser. Whether an arrangement satisfies the model’s participation terms is your compliance team’s determination; the design supplies the reviewer and the record, and the gate is designed to fail closed outside a covered specialty.
How a pilot works →What does it cost and how does it start?
Nothing is for sale on this site. Production terms are set in a pilot and follow a BAA. Start in the sandbox with synthetic requests today.
Run a sample in the sandbox →Run one of your de-identified cases through it.
Two minutes in the sandbox, then a five-field request. The founder reads every one.