Platform

The Complete Medical Coding & Billing Platform

AI-powered coding, real-time eligibility, automated appeals, and enterprise-grade security—all in one platform.

AI-Powered Coding

Claude AI analyzes clinical documentation and suggests ICD-10/CPT codes with confidence scores, reasoning, and automatic PHI sanitization.

  • Code suggestions in seconds
  • Confidence scores
  • PHI sanitization

Eligibility Verification

Real-time 270/271 transactions via Claim.MD verify patient coverage before you bill—including copays, deductibles, and coinsurance.

  • Real-time verification
  • Benefit breakdown
  • Eligibility history
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Appeal Management

12 CARC-specific appeal letter templates with one-click generation and full lifecycle tracking from filing to resolution.

  • 12 letter templates
  • Full tracking
  • Recovery analytics
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Clearinghouse Integration

Claim.MD integration for 837P submission, 835 remittance import, 276/277 status checks, and 270/271 eligibility—all automated.

  • 837P submission
  • 835 auto-posting
  • Daily automation
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Security & Compliance

HIPAA-compliant infrastructure with AES-256 encryption, PHI sanitization, audit logging, and 8-role access control.

  • AES-256 encryption
  • HIPAA audit logs
  • 8 user roles
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Compliance Validation

Validate every claim against LCD/NCD policies, gender rules, CCI edits, and payer-specific requirements before submission.

  • 30 LCD/NCD policies
  • 700+ gender rules
  • Payer rules engine

Authorization Tracking

Track prior authorizations from request to expiration with status monitoring, usage tracking, and claim integration.

  • Status tracking
  • Expiration alerts
  • Claim linking
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And Much More

Complete Revenue Cycle Coverage

Coding Workbench

Split-screen view, keyboard shortcuts, auto-save

Authorization Tracking

Auth storage, utilization, expiration alerts

Fee Schedules

Expected reimbursement, variance tracking

Denial Management

Worklist, CARC analysis, trend reporting

Revenue Dashboard

Executive KPIs, 6-month trends, alerts

Notifications

Real-time SignalR + email alerts

9+ Reports

A/R aging, productivity, compliance

Multi-Tenancy

Agency model, client isolation

See the Platform in Action

Schedule a demo to explore all SmartCoding.ai capabilities with our team.

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