AI Medical Billing
The billing cycle run end to end, with automation where it earns its place.
We run medical billing as a service: charge entry, claim scrubbing, submission, payment posting, denial work and reporting. AI is used where it genuinely removes manual effort, reading documents, flagging likely denials, drafting a first-pass appeal, and not as a label stuck on ordinary billing work.
Tools we work in
- Availity
- Waystar
- Change Healthcare
- Claim.MD
- Office Ally
- athenahealth
- eClinicalWorks
- AdvancedMD
Scope
What this covers
The specific work included when you engage us for this service.
- Charge entry and coding review before a claim leaves the building
- Claim scrubbing against payer rules, so errors are caught before submission rather than after rejection
- Electronic submission through your clearinghouse or through ours
- Payment posting and reconciliation of 835 electronic remittance advice
- Denial triage by root cause rather than by date received
- Eligibility and benefits checks at scheduling and again before the visit
- AI-assisted extraction of clinical details for appeal letters, reviewed by a person before anything is sent
What you receive
- 01A monthly report showing charges, payments, adjustments and denials broken down by payer and by cause
- 02A working denial queue with an owner, a deadline and a status for each item
- 03Documented billing workflows and a written escalation path for what your team should handle internally
Questions
AI Medical Billing, answered
How is this different from a traditional billing company?
Two ways, in our view. Claims are scrubbed against payer-specific rules before submission rather than resubmitted after rejection, and the AI is aimed at mechanical work, reading documents, spotting denial patterns, drafting a first pass, rather than at replacing judgement. Coding and appeal decisions are made by people with clinical context. We will also tell you when an automated step is not worth the complexity it adds.
Can you guarantee we will collect more?
No, and you should be sceptical of anyone who does. What a practice collects depends on its payer contracts, the accuracy of coding, and whether the documentation supports what was billed. What we can control is whether claims leave clean, whether denials are worked inside the payer's deadline, and whether the reasons for denial get fixed upstream instead of recurring.
Do we have to change our EHR?
Usually not. We work inside the practice management system you already run, or through your clearinghouse, so the clinical record stays where it is. The one thing that does change the picture is a system that cannot export claims or remittance data electronically, that is a real constraint, and we would rather flag it before starting than discover it mid-project.
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Revenue Cycle Management
The whole cycle, from patient scheduling to the final payment.
Medical Coding
Diagnosis and procedure codes that match the documentation.
Denial Management & Appeals
Working denials by cause, inside the payer's deadline.
Prior Authorization
Keeping authorisations valid from the order to the date of service.
Tell us where the manual work is
A 30-minute call. We map the process, tell you what we would automate or build first, and what it costs. No retainer before you agree the scope.
- No retainer before scope is agreed
- Written plan you can act on alone
- Worldwide delivery, on your hours