AI Revenue Cycle
Automation for Modern Healthcare
Turn clinical documentation into validated medical claims with AI.
From provider note to posted payment — one continuous pipeline
Every stage is automated and auditable. Providers stay in the loop only where judgment is required.
Twelve systems working as one revenue cycle brain
Click any capability to see how it behaves inside the product.
Suggestions arrive with evidence, not just a code
Each suggested code links back to the exact phrase in the note that supports it, so the provider can accept in seconds — or catch the one time the model is wrong.
- ✓ Confidence score per code
- ✓ Source-text justification
- ✓ ICD-10 and CPT in one pass
A claim assembles itself the moment coding is approved
Patient, payer, encounter, and code data merge into a payer-ready claim automatically — no re-keying between your EHR and your clearinghouse.
Your revenue cycle, at a glance
Every CPT suggestion is checked against NCCI bundling edits, modifier rules, and payer-specific frequency limits before it reaches the provider — so what gets approved is what actually gets paid.
Althais flags diagnosis codes that are too unspecified to bill, missing required laterality, or inconsistent with the documented encounter type — before the claim is built, not after it's denied.
Claims are run through a simulated payer adjudication pass — eligibility, medical necessity, coding edits — so the issues that would trigger a denial are visible and fixable pre-submission.
When a procedure typically requires prior authorization, Althais surfaces it immediately and pre-fills the supporting clinical justification from the note — cutting the manual lookup entirely.
Diagnosis-to-procedure linkage is checked against LCD/NCD coverage policy in real time, so a claim never leaves the building missing the medical necessity it needs to survive review.
Native connections to the clearinghouses billing teams already use — claims submit through your existing rails, with no new vendor relationship to manage.
Althais tracks how each payer actually adjudicates — which edits fire, which modifiers get rejected, which documentation gets requested — and feeds that back into every future claim to that payer.
From submission to remittance, every claim shows live status — submitted, accepted, pending, denied, paid — with automatic follow-up reminders for anything stuck too long.
Every AI suggestion, every provider edit, every claim state change is recorded in an immutable, timestamped audit trail — ready for compliance review at any time.
See it work on your own documentation
Bring a real note. We'll show you the codes, the claim, and the payer checks — live.
Schedule a Demo