Billing / RCM Use Case

Improve documentation quality with structured drafts + E/M support

Assistive billing integrity: surface documentation gaps, propose codes, and keep everything clinician-reviewed. This is not autonomous coding.

Artifact previewStatus scoped per artifact
Billing integrity bundle

AI surfaces MDM gaps and drafts coding cues for clinician review.

Step 01
Normalize
MDM elements
Step 02
Draft
Note + codes
Step 03
Check
Completeness
Step 04
Review
Clinician edits
MDM summary
Requires integration
Problems + data + risk
Code shortlist
Prototype
ICD-10/CPT suggestions
Completeness report
Prototype
Missing fields flagged
gaps surfaced doc completeness
lower denial risk
Workflow snapshot
01
Structured packet
Normalize HPI/ROS + MDM elements.
02
Draft note
Generate clinician-editable drafts.
03
Integrity checks
Surface missing E/M documentation.
04
Coder alignment
Provide suggestions + audit trail.
MDM summary
Problems, data, risk in one view.
draft
Code shortlist
Ranked ICD-10/CPT suggestions.
review
Completeness report
Missing elements highlighted.
Prototype
Workflow + proof points
Structured intake normalizes HPI/ROS + MDM elements.
Draft note with clinician edits required.
Integrity checks surface missing documentation fields.
Suggested ICD-10/CPT codes with confidence.
Audit trail logs suggestions vs accepted edits.
Impact + modules
Impact
Gaps surfaced
Documentation completeness
Gaps surfaced before submission.
Impact
Tracked in pilot
Denial risk review
Cleaner notes with explicit MDM support.
Impact
Consistent
Coder alignment
Structured drafts reduce rework.
E/M integrity checks
MDM and ROS completeness flags.
Code suggestions
ICD-10/CPT candidates with confidence.
Clinician edits
Review-required flow with edit deltas.
Audit trail
Evidence trail for suggested vs final.
Artifacts + rollout
MDM summary card
Problems, data, risk captured in one view.
Suggested codes list
Ranked suggestions with confidence.
Completeness report
Missing elements with remediation tips.
1
Week 1: Policy mapping
Map E/M requirements to your templates.
2
Week 2: Pilot notes
Run on sample notes + coder review.
3
Week 3: Live trial
Limited encounter set with QA.
4
Week 4: Expand
Broaden to additional specialties.
Try it
Billing/RCM use case • clinician review required