medicalbiller.ai
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A category, not a feature · Est. 2026

The first
AI-native
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.

Talk to us→See the work
<$0.50VerifiedCost per autonomous verification call
~90sVerifiedTo classify a denial and draft an appeal
5M+VerifiedRows in the clinical and regulatory knowledge base
4,493,738bundling edit pairs
80+scrub rules
1,000calls at once
5M+row knowledge base
74,719diagnosis codes
~90sdenial to appeal
357national coverage determinations
<$0.50per verification call
308denial-tagged reason codes
40+report types
4,493,738bundling edit pairs
80+scrub rules
1,000calls at once
5M+row knowledge base
74,719diagnosis codes
~90sdenial to appeal
357national coverage determinations
<$0.50per verification call
308denial-tagged reason codes
40+report types
The work, in three movements

Three things, done by machine.

01
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.

<$0.50per verification call, vs $5 to $15 manual
What it does
    01Verifies eligibility, benefits, copay, coinsurance, deductible and out-of-pocket status
    02Captures prior authorization requirements and in or out of network status
    03Navigates the largest national payer phone systems automatically
    04Up to 1,000 concurrent calls, run in batches around the clock
    05Every call recorded, transcribed, and extracted to structured fields
    06Medical-tuned speech recognition for clinical and insurance terminology
02
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.

~90sto assess a denial and draft the appeal, vs 20 to 30 min
What it does
    01Accepts structured API, free text, spreadsheet exports, remittance files, or a form
    02Six-category denial framework with real-denial-versus-adjustment detection
    03Deadline math with receipt-presumption, payer and state filing windows
    04Appeal letters cite the exact reason code, payer rule, or coverage policy
    05Expected success probability per denial, so teams work the winnable ones first
    06Routes to the correct channel: portal, mail, fax, or peer-to-peer
03
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
What it does
    01More than 80 pre-submission scrub rules catch denials before they happen
    02Electronic 837 submission with status polling and full error logging
    03Automatic remittance posting that matches payments and applies write-offs
    04Direct EHR integration and clearinghouse connectivity
    05AR aging, collections, statements, payment plans, and deductible tracking
    06More than 40 report types and real-time financial dashboards
The knowledge base

Five million rows of ground truth.

The facts live in a database, not a model's memory. Codes, coverage, and edits are looked up exactly. The AI judges and writes on top of certainty.

4,493,738Procedure-to-procedure bundling edit pairs
74,719Diagnosis codes
9,068Procedure and supply codes
1,198Remittance advice remark codes
308Claim adjustment reason codes, denial-tagged
949Local coverage determinations
357National coverage determinations
19,000+Medicare fee schedule entries
The manifesto
01

Medical billing is a people business wearing a software costume.

02

Denials are reworked by hand at $25 to $57 each. Eligibility is verified by people sitting on hold.

03

The work is repetitive and rule-bound. It is exactly what machines are good at.

04

Everyone else sells your billing team an AI assistant.

05

We replaced the manual operation with agents, and gave you the control room.

06

This is what a billing company looks like when it is born AI-native.

The lifecycle

One claim, seven hands.

Every claim moves through the same cycle, from charge capture to the final reconciled dollar. At each step a purpose-built agent does the work, and the next one picks up where it left off.

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
Denial benchmarks

Work the winnable denials first.

Not every denial is worth the same effort. The engine scores expected success per category, so a team spends its hours where the dollars actually come back, and stops grinding on the ones that almost never turn.

“Administrative and authorization denials turn nine times in ten. Timely filing rarely does. Triage like it matters.”

Administrative90%
Authorization88%
Coding80%
Medical necessity67%
Eligibility66%
Timely filing25%
Estimated overturn rate by denial category
The difference

One side holds a tool. The other is 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

Born this way
  • 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
Why it is safe

Autonomy with a hand on the wheel.

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.

Questions

The fair
objections.

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.

The flag in the ground

A billing company,

born AI-native.

Talk to us→The first AI-native medical billing company. Supervised by experts, run by agents.