AI-Powered Claim Denial Prediction

aiClaim uses advanced machine learning to predict healthcare claim denials before submission, helping providers maximize revenue and minimize administrative burden.

Prediction Accuracy

80% Prediction Accuracy

Our AI model has demonstrated 80% accuracy in predicting claim denials, significantly higher than industry standards.

EDI and API Support

X12 837 EDI & API Support

Process standard EDI files or integrate directly via our flexible API endpoints.

Denial Workup AI Agent

Coming Soon: Agentic Denial Workup

AI agents that handle denial follow-up automatically to speed resubmission.

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Claim Denial Risk Assessment

Claim #12345 Low Risk (12%)

Claim #67890 Medium Risk (48%)

Claim #24680 High Risk (86%)

Issues detected: Missing modifier, diagnosis code mismatch

Advanced AI for Healthcare Revenue Cycle

Intelligent claim denial prediction that integrates with your existing workflows.

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80% Prediction Accuracy

Our advanced AI model delivers industry-leading accuracy to identify potential claim denials before submission.

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Seamless RCM Integration

Integrates with your existing Revenue Cycle Management (RCM) workflows with no disruption to your current systems.

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X12 837 EDI Support

Easy direct processing of standard X12 837 EDI files with zero additional data preparation needed.

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API Integration

Flexible API endpoints for customized integrations with your existing practice management systems.

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Revenue Optimization

Identify and fix issues before submission to maximize clean claim rates and minimize revenue cycle time.

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Agentic Denial Workup

Coming soon: AI-powered agents that automatically work up denials to speed resubmission and payment.

Integration Options

Multiple ways to connect aiClaim with your existing healthcare systems

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X12 837 EDI Files

Direct processing of standard Electronic Data Interchange ( EDI ) files with no other additional data preparation are needed.

Perfect for: Practices with existing EDI workflows

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API Integration

Flexible REST API endpoints for custom integrations with your practice management systems.

Perfect for: Custom workflows and real-time processing

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Direct EHR Connectors

Direct connections to major EHR and PM systems for seamless data flow (Enterprise only).

Perfect for: Large healthcare organizations

How aiClaim Works

A simple, four-step process to revolutionize your claims management

Upload Claims Data

Upload Claims Data

Submit your X12 837 EDI files or integrate via our API to seamlessly analyze your claims data. Our system processes the information efficiently, identifying key patterns and potential issues. Gain valuable insights to optimize claims management and reduce denials.

AI Analysis

AI Analysis

Our AI engine thoroughly analyzes each claim, comparing it against thousands of potential denial factors. It identifies risks, patterns, and inconsistencies to enhance accuracy and streamline the claims process, minimizing denials.

Receive Predictions

Receive Predictions

Receive comprehensive reports that highlight high-risk claims and pinpoint specific issues. Address potential problems proactively using AI-driven insights to improve claim acceptance rates.

Fix and Submit

Fix & Submit

Review and correct at-risk claims before submission to minimize errors, enhance accuracy, and maximize approval rates — ensuring smoother claim processing and faster reimbursements.