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.
Pilot intro
We’ll share a pilot plan, integration posture, and the fastest path to measurable time-saved.
Artifact previewLive
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
draftProblems + data + risk
Code shortlist
reviewICD-10/CPT suggestions
Completeness report
readyMissing fields flagged
+25% 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.
ready
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
Up to +25%
Documentation completeness
Gaps surfaced before submission.
Impact
Lowered
Denial reduction
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.
Pack snapshot
Workflow spine
Billing integrity that stays assistive and clinician-reviewed.
- 1Structured packetNormalize HPI/ROS + MDM elements.
- 2Draft noteGenerate clinician-editable drafts.
- 3Integrity checksSurface missing E/M documentation.
- 4Coder alignmentProvide suggestions + audit trail.
Documentation completenessDenial reductionAudit-ready drafts
Artifacts
MDM summary
draftProblems, data, risk in one view.
Code shortlist
reviewRanked ICD-10/CPT suggestions.
Completeness report
readyMissing elements highlighted.
Workflow
- 1) Structured intake: Normalize chief complaint + key HPI/ROS elements into a consistent packet.
- 2) Draft note: Generate a clinician-editable note draft.
- 3) Billing integrity checks: Surface missing documentation fields aligned with E/M support.
- 4) Suggested codes: Propose ICD-10/CPT suggestions with confidence, always review-required.
- 5) Audit trail: Track what was suggested vs what clinicians accepted/edited.
Designed for RCM reality
Assistive only
reviewNever auto-submit codes; clinicians remain responsible.
Gap surfacing
QAHighlight missing ROS/MDM elements needed for support.
Edit deltas
deltaMeasure how outputs change from AI draft to final.
Telemetry
metricsAcceptance rate, latency, and cost per encounter.
Impact
Up to +25%
Documentation completeness
Gaps surfaced before submission.
Impact
Lowered
Denial reduction
Cleaner notes with explicit MDM support.
Impact
Consistent
Coder alignment
Structured drafts reduce rework.
Module stack
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 your team sees
MDM summary card
Problems, data, risk captured in one view.
Suggested codes list
Ranked suggestions with confidence.
Completeness report
Missing elements with remediation tips.
Implementation plan
- 1Week 1: Policy mappingMap E/M requirements to your templates.
- 2Week 2: Pilot notesRun on sample notes + coder review.
- 3Week 3: Live trialLimited encounter set with QA.
- 4Week 4: ExpandBroaden to additional specialties.
Try it
Billing integrity pilot
We’ll tailor documentation checks + measure impact on completeness and downstream edits.
Billing/RCM use case • clinician review required