Coding is where it starts. From there, InteliClaim covers the money, the recovery, and the reach, so you're not stitching five vendors together.
General tools force every specialty through a physician-office mold. InteliClaim ships specialty packs that add the coding rules, reference data, and documentation prompts each field actually needs, with no change to the base flow.
Drug-administration billing, J-code / NDC capture, biosimilars, and infusion hierarchy.
Procedure-specific coding rules and cardiac reference data.
Neurology master data and specialty coding rules.
Implant catalog and documentation requirements wired into the claim.
UDT frequency and device-interval medical-necessity rules.
Mental-health parity (MHPAEA) rules built into the engine.
Laterality captured and carried through to claim modifiers.
Nephrology reference pack on the shared specialty rails.
You decide how much the AI runs on its own. Keep a person on every claim, or let the routine flow and put your reviewers where the risk actually is.
A qualified reviewer approves every claim by default. Switch on auto-mode and only work below your confidence threshold routes to a person, the routine, high-confidence coding flows through. The line is a clinic setting you control.
Per-clinic confidence thresholdA live next-best-action view across coding, pre-auth, claims, ERA, denials and collections, ranked by the dollars at risk, so your team always works the item that recovers the most money next.
Role-aware · priority-scoredA primary model with automatic fallback to a second, so a single provider outage never stops coding, claims or appeals. Documented for your procurement team.
Multi-model failoverBook a demo or call us, and we'll run InteliClaim against your own workflow and payer mix.