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How It Works

One Encounter,
Start to Finish

Scroll through exactly what happens between a doctor finishing a note and Althais posting the payment.

STEP 01 / 09
Documentation

The doctor writes a note. That's it.

No coding cheat sheets, no structured templates to fight. Althais works with documentation exactly as it's written.

S — Subjective
58F presents with substernal chest pressure x2 hrs, radiating to left arm. Diaphoretic, mild SOB.
O — Objective
BP 152/94, HR 108, EKG shows ST elevation in leads II, III, aVF. Troponin elevated at 2.4.
A / P — Assessment / Plan
Acute inferior STEMI. Emergent cardiology consult, cath lab activated. High-complexity ED visit.
STEP 02 / 09
AI Analysis

AI reads the note like a coder would

Diagnoses, procedures, and modifiers are identified directly from clinical language — not keyword matching.

  Diagnosis   Procedure   Modifier
BP 152/94, HR 108, EKG shows ST elevation in leads II, III, aVF. Troponin elevated at 2.4.
Acute inferior STEMI. Emergent cardiology consult, cath lab activated.
High-complexity ED visit, critical care time 45 minutes documented separately.
STEP 03 / 09
Code Generation

Validated ICD-10 and CPT codes, with confidence

Every code ships with a confidence score, so the provider knows exactly where to focus their review.

I21.19
STEMI involving other coronary artery of inferior wall
97%
99285-25
High-complexity ED visit, significant separate service
91%
99291
Critical care, first 30–74 minutes
84%
STEP 04 / 09
Provider Review

The provider stays the final word

Accept in one click, edit a code inline, or reject it entirely. Nothing bills without a human decision.

99291
Critical care, first 30–74 minutes
84%
✓ Accept Edit Reject
STEP 05 / 09
Claim Assembly

The claim assembles itself

Approved codes, patient data, and encounter details merge into one payer-ready claim automatically.

I21.19 99285-25 99291 Anthem BCBS · Claim #A-88214
StatusReady to submit
STEP 06 / 09
Payer Intelligence

Payer rules checked before submission

The claim runs against Anthem BCBS's own edit history — bundling, medical necessity, modifier logic — before it ever leaves.

NCCI bundling edits — clear
Medical necessity (LCD/NCD) — clear
Modifier appropriateness — clear
Prior authorization requirement — clear
STEP 07 / 09
Submission

Submitted through your clearinghouse

No new vendor, no new login. The clean claim goes out through the rails you already use.

Claim #A-88214 transmitted to Anthem BCBS
STEP 08 / 09
Claim Tracking

Real-time payment tracking

Status flows back automatically — no logging into a payer portal to find out what happened.

SubmittedAcceptedAdjudicatedPaid
Paid amount$1,842.00
STEP 09 / 09
Analytics

Every encounter feeds the bigger picture

Clean claim rate, denial rate, and days in A/R update the moment this claim posts.

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Clean claim rate
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Denial rate
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Days in A/R
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Avg. revenue / provider / day