Healthcare
Prior authorisation packets
Prior authorisation requests are assembled from the record against each payer's criteria, with missing evidence flagged, then submitted by staff.
Agent
Healthcare · Custom app
Clinical coding support
AI clinical coding support for coders and billing teams
Coders get a ranked list of candidate codes with the supporting text from the record, looked up in the official code sets, for them to accept or change.
01 today
The problem
Coders read long records to assign diagnosis and procedure codes, and backlogs delay billing. Missed or vague documentation leads to wrong codes and denied claims. General AI chatbots are not reliable at this on their own: they often produce codes that do not exist.
02 the run
What the AI does
- Step 1: Reads the finished encounter or admission record once it is signed.
- Step 2: Finds the statements that support a diagnosis or procedure, such as the reason for a test or the operation performed.
- Step 3: Looks up candidate codes in the official code set, such as ICD-10-CM, ICD-10 and OPCS-4, or CPT, rather than writing codes from memory.
- Step 4: Ranks the candidates and shows the exact sentence that supports each one.
- Step 5: Flags documentation gaps, such as an unspecified condition, so a query can go to the clinician.
paused: waiting for a person to approve
03 human in the loop
Where a person approves
Certified coders choose every final code. Queries to clinicians are written or approved by a coder, and the tool never changes the clinical record.
04 after
What changes
Coders spend their time on judgement rather than searching, and backlogs shrink. Codes are better supported by the record, which helps when claims are reviewed.
Case studyHelping coders clear the backlog without trusting AI to guess codesThe rollout, what to measure, a worked example and the research behind it.see also
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Incoming referrals are read, checked for missing information and routed to the right service, with urgency confirmed by a clinician.
Automation
Tell us how your business runs. We'll tell you where AI fits.
A free 30-minute call. You talk, we ask questions, and you leave with a few concrete ideas — or an honest answer that AI isn't the right fix yet.
Working with teams around the world.