System onlineAgents working every claim

The first AI-native medical billing company.

Not billing software you bolt onto a team. The billing operation itself, rebuilt AI-first, where autonomous agents work every claim from the first call to the final dollar.

VERIFIED
<$0.50
Cost per autonomous verification call
VERIFIED
~90%
Reduction in manual calling effort
TARGET
<$5
Target cost per denial reworked, vs $25 to $57 industry
VERIFIED
~90s
To classify a denial and draft an appeal
01Live Operation

Watch one claim go from denied to paid.

No humans on the phone. No claim left behind. Every stage is run by an agent, with a person approving anything that gets filed. This is the loop, running live.

Claim Lifecycle / Live
CLM-#48217
01
Capture
02
Verify
03
Scrub
04
Submit
05
Post
06
Appeal
07
Settle
ClaimCapture
$412.00CPT 99214
clean / in flight
agent.console
02Three Pillars

Three engines. One autonomous operation.

Voice agents that call your payers, denial intelligence that overturns by machine, and a single platform that runs the entire revenue cycle.

Pillar 01

Agents that call your payers

Autonomous voice agents dial insurance companies, navigate phone trees, sit on hold, and converse with reps to verify coverage, then hand you back clean structured data.

<$0.50
per verification call, vs $5 to $15 manual
  • Verifies eligibility, benefits, copay, coinsurance, deductible and out-of-pocket status
  • Captures prior authorization requirements and in or out of network status
  • Navigates the largest national payer phone systems automatically
  • Up to 1,000 concurrent calls, run in batches around the clock
  • Every call recorded, transcribed, and extracted to structured fields
  • Medical-tuned speech recognition for clinical and insurance terminology
Pillar 02

Denials, overturned by machine

Drop in a denied claim in any format. It is classified against a five million row knowledge base, the appeal deadline is calculated, and an edit-ready appeal letter is drafted with cited evidence.

~90s
to assess a denial and draft the appeal, vs 20 to 30 min
  • Accepts structured API, free text, spreadsheet exports, remittance files, or a form
  • Six-category denial framework with real-denial-versus-adjustment detection
  • Deadline math with receipt-presumption, payer and state filing windows
  • Appeal letters cite the exact reason code, payer rule, or coverage policy
  • Expected success probability per denial, so teams work the winnable ones first
  • Routes to the correct channel: portal, mail, fax, or peer-to-peer
Pillar 03

One platform, the whole cycle

The system of record for everything. Charge capture, clean-claim scrubbing, clearinghouse submission, automatic payment posting, accounts receivable, collections, credentialing, and reporting.

80+
scrub rules that prevent denials at the source
  • More than 80 pre-submission scrub rules catch denials before they happen
  • Electronic 837 submission with status polling and full error logging
  • Automatic remittance posting that matches payments and applies write-offs
  • Direct EHR integration and clearinghouse connectivity
  • AR aging, collections, statements, payment plans, and deductible tracking
  • More than 40 report types and real-time financial dashboards
03How It Works

Seven stages. Each one has an agent.

The revenue cycle, run as an instrument. Each stage names the agent on duty and what it does.

01CaptureCharge and clinical intake, coded per visitIntake agent
02VerifyVoice agent calls the payer and confirms coverageVoice agent
03Scrub80+ rules check the claim before it leavesScrub agent
04SubmitElectronic 837 to the clearinghouseSubmit agent
05PostRemittance matched and posted automaticallyPosting agent
06AppealDenials classified and appealed in ~90 secondsDenial agent
07SettlePaid, reconciled, and reportedAR agent
05The Brain

The brain behind every decision: a 5 million row knowledge base.

Codes, coverage policies, and bundling edits are exact database lookups, not model guesses. The AI judges and writes. The facts come from here.

4,493,738
Procedure-to-procedure bundling edit pairs
74,719
Diagnosis codes
9,068
Procedure and supply codes
1,198
Remittance advice remark codes
308
Claim adjustment reason codes, denial-tagged
949
Local coverage determinations
357
National coverage determinations
19,000+
Medicare fee schedule entries
06Denial Benchmarks

Not every denial is winnable. We score which ones are.

Each denied claim gets an expected success probability before a single minute is spent. Administrative and authorization denials overturn at high rates. Timely-filing rarely does. Teams work the winnable ones first.

Administrative
90%
Authorization
88%
Coding
80%
Medical necessity
67%
Eligibility
66%
Timely filing
25%

success probability scored per denial → work the winnable ones first

07Safety Architecture

Autonomy with a hand on the wheel.

The fastest way to lose trust in AI billing is a hallucinated code. We engineered that possibility out.

01

Deterministic before generative

Codes, coverage policies, and deadline math come from exact database lookups. The AI judges and writes. It does not invent the facts, so it cannot hallucinate a code or a deadline.

02

A human on every consequential move

Agents draft appeals and surface recommendations. A person approves before anything is filed. Autonomy with a hand on the wheel.

03

Every action is auditable

Each classification, call, and posted payment records the evidence and the model that ran it, so any decision can be reviewed end to end.

04

Built for protected health information

Encryption in transit and at rest, role-based access, and activity logging throughout. Claim identity stays operator-controlled.

08The Difference

Everyone else sells your team a tool. We rebuilt the operation.

The old way

  • Offshore callers on hold all day
  • Denials reworked by hand, one at a time
  • Software bolted onto a manual team
  • You manage the people

medicalbiller.ai

  • Voice agents call payers, 1,000 at once
  • Denials classified and appealed in ~90 seconds
  • Agents are the operation, not an add-on
  • You watch the dashboard
10Objections, Defused

The questions every operator asks.

Yes. The facts come from the knowledge base by exact lookup, the AI only judges and drafts, every action is logged, and a human approves anything that gets filed. Encryption and role-based access run throughout.

Take command

Stop managing the people. Start watching the dashboard.

See the live pipeline on your own claims. We will run a denial through it on the call.