Fewer denials, cleaner claims, faster reimbursement, across coding, prior authorization, and appeals. InteliClaim does the work in minutes and attaches the source evidence to every decision, with your team in control of how much runs on its own.
Denials, downcoding, and prior-auth drag are, underneath it all, an evidence problem.
The chart usually holds everything needed to justify a code, meet a payer's criteria, or overturn a denial. The work is finding it, connecting it, and writing it down, under time pressure, at volume, for every encounter.
InteliClaim does that connecting work and shows it. Not a score you're asked to trust blindly: the actual line in the note behind every code, every criterion, every citation. Built to be checked by the people who sign off on it.
Coding, prior authorization, and appeals share the same core skill: read the record, and prove your case from it. InteliClaim does exactly that, and leaves the decision with your team.
Pt presents with productive cough and fever 38.9 °C. CXR shows right lower lobe consolidation consistent with pneumonia. History of tobacco use.
Payer denied the CT as not medically necessary.
Imaging is clinically indicated given persistent hemoptysis and an abnormal chest x-ray, per Policy MP-204 and ACR criteria.
InteliClaim understands the encounter once, then works it end to end, from the first code to a submitted appeal, with your reviewers in control of how much runs on its own.
ICD-10, CPT and E/M proposed with a confidence score and the exact line in the note behind each one. Nothing to trust blindly.
InteliClaim checks the payer's medical-necessity criteria against the chart before you submit, and flags exactly what's missing while it can still be fixed.
Turn a denial code into a defensible appeal letter, pulled from the record, backed by payer policy and clinical criteria, ready for a reviewer to send.
It flags missing or contradictory documentation before it becomes a denial, and suggests a query for the physician.
Denial rates, turnaround, and recovered revenue tracked per payer and service line, so the value is a number, not a promise.
Role-based worklists, coding locks, and one-click sign-off keep qualified people in control, from every claim to just the exceptions you route them, with a full audit trail behind them.
Standards-based connectivity over FHIR, so InteliClaim reads the chart where it already lives. No rip-and-replace, no double entry.
Payer-ready claims with built-in checks that catch errors before they leave the practice, not after a rejection comes back.
Incoming remittances matched to claims, with underpayments and denials surfaced the moment they land, so nothing sits unworked.
Manual coding and single-purpose AI tools each solve a slice. InteliClaim runs the whole revenue cycle, coding to paid to patient statement, with the evidence attached at every step.
| Manual / legacy | AI coding tools | InteliClaim | |
|---|---|---|---|
| Scope | Coding only | Coding only | Full revenue cycle |
| Evidence behind each output | — | Confidence score | Confidence score + the exact note line |
| Human review | — | Varies | Every claim, or set a confidence threshold |
| Prior authorization | Manual | Not included | Built in |
| Denials & appeals | Separate tool | Separate tool | Built in, appeals drafted |
| Works with your EHR | — | Varies | FHIR, no rip-and-replace |
| Specialty coding rules | Generic | Generic | Specialty packs |
| Enterprise security | Varies | Marketing PDFs | Tenant isolation + audit, day one |
| Time to live | Months | Weeks | Days |
Denial Shield checks every claim against payer-specific denial patterns using the same evidence-linked engine that powers coding, and it runs before you submit, not after a rejection lands. Denial management becomes prevention, not clean-up.
InteliClaim tracks denial rates, turnaround, and recovered revenue per payer and service line, so you can prove the impact to your CFO, not just feel it.
Move the sliders. This is a rough model, not a quote, but it shows the shape of the opportunity.
Illustrative only. We'll build a real model against your payer mix on a call.
A focused product in production, described honestly, no inflated numbers.
InteliClaim reads the chart (notes, results, orders) and understands the encounter in clinical context.
It proposes codes, checks payer criteria, or drafts an appeal, each with a confidence score.
Every output links to the exact evidence in the record, so it can be trusted, or challenged, on the spot.
A qualified reviewer approves, edits, or rejects. Only then does anything leave the building.
Protected health data and payer decisions leave no room for a black box. Trust isn't a feature bolted on here. It's the architecture, from the first commit.
Every code, criterion and citation carries its evidence. Nothing InteliClaim proposes is a number you're asked to trust blindly.
The system proposes; a qualified coder or clinician disposes. People stay in control and set how much the AI may do on its own.
PHI is handled under least-privilege access, with US healthcare regulation shaping the architecture from the ground up.
Data is encrypted in transit and at rest with AES-256, and every customer's data is walled off with strict tenant isolation.
We don't train foundation models on your charts. What's yours stays yours.
Role-based access and a detailed audit trail on every action, so any coding or appeal decision can be reviewed after the fact.
MFA, single sign-on, and SCIM provisioning keep your directory the source of truth, so access is granted and revoked the moment someone joins or leaves.
Suspicious or manipulated inputs are detected and routed to a human, so a crafted note can't steer the AI into an unsafe output, a safeguard black-box tools can't show you.
Emergency access is time-boxed, reason-required, and completely audited, and tenant isolation stays enforced even then.
On certifications: We're working toward formal certification as we scale, and confirm our compliance posture per engagement. Tell us your specific requirements and we'll walk you through how we meet them. See our full trust overview →
Start with a paid pilot on one workflow, then scale to what earns its keep. Coding is usage-based; the full RCM suite is custom to your volume.
The fastest way to know if InteliClaim fits your revenue cycle is a real conversation. No forms-first funnel. Pick up the phone and talk to the people who built it.
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