Does it automatically code, bill or submit claims?

No. AiMediCoder surfaces potential issues, explains the risk and suggests next actions. Qualified people on your team make every coding, clinical, billing, appeal and submission decision.

Is this only for behavioral health?

Behavioral health is our starting specialty because its documentation, authorization and time-based coding patterns are distinctive. The model is designed so other specialties could be added later.

Are integrations live today?

Not as plug-and-play connectors. Pilots typically begin with scoped data extracts (for example claim, remittance and authorization files). Integrations are discussed case by case, as available.

What metrics is a pilot based on?

Measures are agreed up front — for example how many flagged issues reviewers judged valid, how actionable the suggested next steps were, and time to triage. We don't promise recovery amounts.

How do you handle PHI?

Security, data handling and any agreements required are defined during pilot scoping before any data is shared. Please do not send patient or protected health information through our public contact form.

Revenue intelligence for modern RCM teams

Know where revenue is at risk. Know what to do next.

AiMediCoder helps RCM companies connect the dots across their client portfolios—from eligibility and documentation gaps to denials and recovery opportunities. Built for US healthcare. Starting with behavioral health.

Discuss a Pilot Explore the Platform

Works alongside your EHR, PMS & clearinghouse · Human review on every decision

Portfolio overview

Illustrative demo — synthetic data

Est. exposure

$119,150

across 4 clients

Open issues

12 due this week

Needs leader review

escalations

Northbend Counseling Group: Auth units nearing limit

37 open items · owner Priya S. · suggested next step awaits human review

The gap

Your team sees claims. Leadership needs to see the revenue at risk.

Across a dozen provider clients, risk lives in different systems, spreadsheets and inboxes. By the time a pattern is visible, it has usually become a denial — and nobody is quite sure who owns the fix.

Disconnected workflows

Eligibility, coding QA and AR each work from their own tools. No one sees the full account story.

Late risk detection

Problems surface after the payer says no — when fixing them costs the most time and money.

Unclear accountability

Issues get noticed but not owned. Without an owner and due date, recoverable work quietly ages out.

Portfolio-wide visibility

From organization to client to claim, in three clicks.

Start with estimated exposure across every account. Drill into a client's prioritized worklist. Open a single issue to see the evidence, owner and due date.

Exposure ranked by account
One prioritized worklist per client
Every issue has an owner and a date

Try it — click a client, then a claim.

Illustrative demo — synthetic data

Estimated exposure by client — select to drill in

Three moments that matter

Catch it earlier. Fix it with evidence.

Every signal follows the same shape — risk → evidence → next action → owner → due date — so it can be reviewed, assigned and closed. Suggestions always require human review.

Where we look

Eligibility & benefits
Authorization limits & renewals
Provider credentialing / enrollment

Example signal (synthetic)

Two authorized sessions remain; next visit scheduled after renewal date.

RiskEvidenceNext actionOwnerDue date

Behavioral health first

A specialty where the details decide the payment.

Behavioral health revenue depends on patterns general-purpose tools often miss. We start here so the signals are specific, not generic.

Why behavioral health

Session documentation

Start/stop times, medical-necessity language and treatment-plan alignment in progress notes.

Time-based CPT considerations

Psychotherapy codes such as 90832 / 90834 / 90837 depend on documented session duration.

Authorization limits

Visit or unit caps, renewal windows and level-of-care changes for IOP and PHP.

Telehealth & payer rules

Place-of-service, modifiers and payer-specific telehealth requirements that vary by plan.

Informational only — not medical, coding or legal advice. Payer rules vary and are confirmed by your team.

For every seat

Built for RCM operators. Designed for leadership.

Portfolio exposure at a glance.

See which client accounts carry the most estimated risk, where issues are aging and what to raise in the next client review.

Account-level exposure
Escalations needing a decision
Client-ready summaries

How it works

Four steps, starting with the data you already have.

Connect data

Scoped extracts — claims, remits, authorizations — or integrations where available.

Identify potential leakage

Review across the lifecycle highlights issues and estimated exposure.

Prioritize & assign

Rank by exposure and urgency. Give every issue an owner and due date.

Review, resolve & measure

Humans decide. Status trails show what happened and what it was worth.

See the full workflow

Evidence, not just alerts

Every issue carries its reasoning and its history.

Reviewers see why something was flagged, what supports it and what should happen next. Leaders see a transparent trail of who did what, and when.

ISS-3381AttentionIllustrative demo — synthetic data

Session duration missing for time-based code

Northbend Counseling Group · CLM-20418 · Est. exposure $186

Suggestion only. A qualified coder or reviewer makes the final decision.

Status trail

Flagged by pre-submission review
Oct 09 · 09:12
Assigned to QA Lead
Oct 09 · 11:40
Addendum requested from provider
Oct 10 · 14:05
Human reviewer confirms resolution
Pending

Works alongside your stack

No rip-and-replace. A layer of intelligence above the EHR, PMS, clearinghouse and AR tools your teams already use.

Human-in-the-loop

AI explains risk and recommends. Your qualified people decide on coding, clinical, billing and appeals.

Multi-client by design

Built around how RCM companies actually work: many providers, many payers, one accountable team.

An honest pilot

We're early. So we start small and measure together.

No inflated ROI, no fixed timeline we can't back up. A focused pilot shows whether the signals are accurate and useful for your team.

Pilot program details

Define pilot scope

Choose client accounts, workflows, data and success measures with your leadership.

Review sampled workflows

Run the review on scoped data. Your experts validate every flagged issue.

Measure signal and actionability

Assess how often flags were valid and whether next actions were useful.

In short

What AiMediCoder is — and isn't.

What is revenue protection and recovery intelligence for RCM companies?

It is a review layer that looks across an RCM company's client accounts to highlight where revenue may be at risk — before service, before claim submission and after denial — and attaches evidence, a suggested next action, an owner and a due date so people can act on it.

How can an offshore RCM company compare risk across clients?

By looking at estimated exposure, open issues and aging per client account in one portfolio view, then drilling into each client's prioritized worklist. See the platform overview.

What is the difference between exposure, potential recovery and collected revenue?

Estimated exposure is revenue that may be at risk. Potential recovery is the portion that might be recoverable with action. Verified recovered collections are payments actually received. We always report them separately — see the RCM glossary.

Questions

Straight answers.

No. It is designed to sit alongside your existing EHR, practice management, clearinghouse, coding and AR tools, and add a portfolio-level layer of risk visibility and accountability.