Solutions · Autonomous Coding
Every claim, coded against the chart it came from.
Adentris reads every line of every claim against the underlying chart. Flags E/M under-coding, missing add-ons, modifier errors, NCCI bundles, LCD gaps. The recoverable dollars stop hiding.
$640–$1,225 Recoverable revenue per 10 claims. Customer-validated benchmark across specialty groups, ASCs, and behavioral health.
The problem
Under-coding is the silent revenue leak.
How it works
Every claim, every code, against the chart.
Read chart and claim
The AI Web Agent pulls the encounter chart and the candidate claim from the EHR or billing system, joined on the visit ID.
Test against the stack
CPT, ICD-10, HCPCS, modifier rules, NCCI bundles, LCDs, and your payor-specific overlays. Every code is justified by a chart citation.
Suggest with confidence
Missed E/M level. Missing add-on. Modifier correction. Bundle conflict. Every suggestion comes with a confidence score and the supporting chart line.
Coder approves
A credentialed coder reviews each suggestion, accepts or overrides. Audit log records the decision. Claim leaves billing clean.
What you get
Captured revenue, measured per claim.
What impressed us was not just the speed — it was the structure. Adentris transformed hundreds of pages of policies into a practical, clinically relevant control framework and applied it across massive patient records without the operational burden of manual chart review.
Parker Smith
CEO, Simplifyance
Side by side
Adentris vs the alternatives.
Capability
Adentris
Manual coding QA
Other coding-AI tools
Claim coverage
100%, every specialty, every payor
5–10% sample audit
100% within scoped specialty
When suggestions surface
Pre-bill, every specialty, with chart citation
Days to weeks post-bill
Pre-bill, scoped specialties
Platform scope
Coding, documentation, prior auth, appeals, discharge on one platform
Coding only
Coding only
EHR integration
AI Web Agent, no API, any EHR, live in 60 days
Reviewer logs in manually
API or partnership, multi-month project
Behavioral health support
42 CFR Part 2 architecture, ASAM rule logic
Variable
Limited
01 Which code sets does Adentris support?
CPT (HCPCS Level I), HCPCS Level II, ICD-10-CM, ICD-10-PCS, NCCI edits, LCDs, and payor-specific overlays. Code sets are refreshed quarterly and on any out-of-cycle CMS update.
02 Does this replace our coders?
No. Adentris flags every chart-vs-claim mismatch with a confidence score and the supporting chart reference. Your coders review, accept, or override. Most customers keep their coding team and free them from line-by-line audits so they can focus on edge cases and education.
03 What specialties is this trained on?
Inpatient, behavioral health, substance use disorder, ambulatory surgery, ortho, GI, cardiology, pain management, dermatology, ophthalmology, and primary care. Specialty rule libraries are versioned per facility. New specialties added with a 30-day cohort review.
04 How accurate are the coding suggestions?
Customer-validated 98%+ accuracy on E/M and modifier suggestions when confidence score is above 0.85. Below 0.85 the finding is flagged for coder review with the reason. No suggestion is auto-billed; a credentialed user approves before submission.
05 Will it work with our payor mix?
Yes. Payor-specific rule overlays are loaded at deployment for your dominant payors (commercial, Medicare, Medicaid, Medicare Advantage, BH carve-outs). New payors add in days, not weeks.
06 How is this priced?
Free tier with 5 claim audits per month per user. Starter at $100/month for 25 per user. Enterprise is annual, tied to provider count and monthly claim volume, includes EHR integration via AI Web Agent, custom payor rules, dedicated CSM, BAA, and SLA.
See Autonomous Coding on your claims.
Book a live walkthrough on a sample of your claims, or ship us 60–90 days of EOBs + paired charts and we'll send a written report with the dollar uplift per 10 claims by specialty and coder.