Billing & Coding Compliance
Catches upcoding before it ships.
Not a chatbot, a pharma & life sciences specialist. Continuously checks clinical documentation against payer rules and regulations, flagging the entries that would draw a penalty. The code is yours.
- Reference masters
- Documents & forms
- Historical data
- Scored recommendations
- Audit-ready evidence
- Decision log entries
Why this work breaks at scale.
Done by hand, it's slow, error-prone at volume, and gets pricier with every head you add. The bottleneck is the swivel-chair between systems, not effort.
What the Billing & Coding Compliance does for your team.
Deterministic where it matters
Regulated or high-stakes steps follow fixed, testable workflows, generative help is reserved for drafting and ideation.
Reads what you already have
Ingests documents, records, and messages in the formats your pharma & life sciences stack produces, no clean-room data prep required.
Writes a complete audit trail
Every step is timestamped and reversible, giving you 100% coverage for internal review and external audit.
Human-in-the-loop by design
Routine cases run end-to-end; anything above your confidence or value threshold is routed to a person with the full context attached.
Triage to discharge, one clinical view.
Intake
Captures the request and assembles everything needed to act on it.
Reason
Runs the deterministic checks first, then applies judgment where it helps.
Execute
Completes the task across the connected systems in one pass.
Report
Returns the result, the rationale, and the trail in one place.
- Reference masters
- Documents & forms
- Historical data
- Email & chat
- Scored recommendations
- Audit-ready evidence
- Decision log entries
- Posted transactions
Deployed into the systems you already run.
No rip-and-replace. The Billing & Coding Compliance connects to your existing pharma & life sciences tooling and writes back to your system of record.
Deployed for Revenue-integrity teams — lower compliance risk.
The practical details.
A first version typically runs against your own data within weeks, the first agent can be live in as little as 48 hours, with full deployment in two to eight weeks.
Yes. You own 100% of the IP, code, and documentation. There is no platform lock-in and the full system transfers to your team.
No. It removes the low-judgment, repetitive work and routes anything consequential to a person with the context attached, so your team spends time where judgment actually pays off.
It integrates with the pharma & life sciences systems you already run, Epic, Cerner, FHIR and more, with no rip-and-replace.