How Syntra Uses Pulse to Process $1B+ Of Medical Charges a Year

Medical billing teams spend enormous time extracting information from messy, real-world documents. Clinics submit PDFs, scans, handwritten notes, photos, and email attachments, often with inconsistent formatting and quality. 

Syntra set out to solve this problem with an agentic billing system that automates the entire lifecycle of medical billing. To make the agentic workflow reliable, they needed a document intelligence layer that was accurate, compliant, and scalable across a large network of clinics.

Pulse became that layer.

Syntra’s rapidly scaling agentic billing system today processes over a million documents and hundreds of millions of dollars of medical charges every month. Without a reliable ingestion layer, this scale would require substantial manual work and introduce errors that slow down claims and automation.

‍About Syntra‍

Syntra is an agentic billing system for in-house medical billing teams. Its platform transforms billing from a manual, error-prone workflow into a fully automated system that reads, understands, and processes clinical documents at scale. Syntra delivers faster charge capture, cleaner claims, and real revenue lift for healthcare providers.

The Challenge

Syntra’s customers send documents in every format possible. That includes scanned PDFs, photos of paperwork, printed reports, emailed attachments, and handwritten notes from physicians. Many contain medical abbreviations, handwriting, or low-quality images that traditional OCR fails to interpret correctly.

Before integrating Pulse, this variability forced teams to handle data ingestion manually or build one-off logic for each clinic. It slowed onboarding and reduced confidence in downstream agent pipelines.

Syntra needed a single, reliable ingestion layer that could support:

• Hundreds of thousands of pages per month
• Zero data retention for PHI
• Deterministic structured output for agent reasoning
• Handwritten and scanned inputs
• Auditability and traceability for compliance

Why Pulse

After evaluating other OCR and LLM-based tools, Pulse was selected as the core document intelligence system inside Syntra’s platform.

Pulse provided:

• Accurate extraction across PDFs, scans, images, and handwritten documents
• Structured JSON output ready for agent pipelines
• Zero Data Retention with full encryption for healthcare compliance
• Real-time ingestion at scale
• Out-of-the-box deployment without custom integrations
  

Pulse fits into Syntra’s architecture as a behind-the-scenes engine. Clinics do not need to change how they send data. Syntra simply routes documents to Pulse, receives clean structured data, and feeds it into agentic workflows.

"Pulse lets us handle messy real-world inputs in every clinic. We process hundreds of thousands of pages a month with zero retention and complete reliability. That allows us to trust the data in our downstream agentic pipelines."  
- Ayush Jain, CEO at Syntra 

Implementation

Pulse is integrated directly into Syntra’s billing stack. When a clinic uploads documents in any format, Syntra forwards them through the Pulse API (both cloud and on-prem) and receives clean, auditable extraction. The output includes bounding boxes, field structure, and confidence scores, which map into Syntra’s internal billing models.

No custom logic is required for new clinics. Pulse ingests data as is, which eliminates the need for Syntra’s engineering team to write ingestion code for each new customer.

Pulse runs in a fully encrypted environment with zero retention, aligning with HIPAA and other healthcare security and compliance needs.

Impact

Syntra’s billing engine is now powered by a deterministic document intelligence layer that delivers fast, accurate, and structured data without human review.

Key results:

• Hundreds of thousands of pages processed every month
• Faster billing cycles and reduced manual QA
• Reliable input for agentic workflows
• Easily scalable as Syntra adds more clinics
• No custom ingestion logic required per customer
• Zero retention extraction for PHI and healthcare compliance

"We tested other OCR and LLM-based approaches, including Claude, Gemini, and a few vendor tools. Pulse was the only one that consistently handled the real-world documents we see across clinics. It is fast, accurate, and reliable, so it has become core infrastructure for us. The support experience has also been great. We have never waited more than ten minutes for a response from the Pulse team"

- Aniketh Kolla, CTO at Syntra 

Looking Forward

Syntra is continuing to expand Pulse across more clinics and additional document types. Pulse now serves as the universal ingestion layer for medical billing data inside the Syntra platform. By combining deterministic extraction with agentic reasoning, Syntra delivers faster reimbursements, fewer denied claims, and a smoother experience for providers and billing teams. The Pulse team is excited to support Syntra as they scale exponentially and continue to work with some of the largest healthcare institutions in the world.