Your AI workforce for the revenue cycle.
Medikode deploys specialized AI agents across coding, audit, validation, risk adjustment, and remittance — working alongside your team, 24/7. Now also implementing agentic AI inside your hospital’s RCM workflows.
Five AI agents, working the cycle.
Each agent is purpose-built for one revenue-cycle workflow. They reason through multi-step payer logic, run inside your own infrastructure, and keep your team in control of every exception.
Coding Agent
ICD-10 & CPT codes from clinical text at ~95% accuracy, specialty-tuned and payer-aware.
Audit Agent
Verifies assigned codes against the chart documentation — every code, evidence-checked.
Validation Agent
Checks code-pair combinations against compliance edits — catches conflicts before submission.
Risk Adjustment Agent
Computes RAF scores from demographics & conditions using CMS-HCC models, including V28.
Remittance Agent
Converts EOB documents into standardized ERA output — clean, postable remittance data.
Coming next on the roadmap
Eligibility Agent
Real-time coverage and benefits verification.
Prior Auth Agent
Submits, tracks, and follows up on authorizations.
Claims Agent
Scrubs and submits clean claims against payer edits.
Denial Agent
Diagnoses denials and drafts targeted appeals.
AR Collections Agent
Outbound follow-up and payer-portal navigation.
Bring the agents inside your hospital.
Beyond software: hands-on implementation of agentic AI across your hospital’s revenue cycle. We design the workflow, deploy the agents, integrate with your EHR and billing systems, and run change management with your team — done with you, not for you.
- RCM workflow assessment — current state, automation candidates, ROI map.
- Agent deployment — configured for your specialties, payers, and facility setup.
- EHR & billing integration — Epic, Cerner, Meditech, athena, and more.
- Change management — coder training, exception workflows, governance.
- Outcome reporting — denials, throughput, accuracy, and revenue lift, tracked monthly.
Numbers that move the cycle.
What customers see when the agents and the workforce share the load.
Reduction in RCM cost
Coding accuracy
Fewer claim errors
Throughput, no burnout
Built different, on purpose.
A platform, not a point tool.
Five agents live today, more on the roadmap. Start where the ROI is sharpest and expand across the cycle without stitching vendors.
Real agentic reasoning.
Multi-step logic that adapts when payer rules change — not RPA scripts that snap on the first exception.
Your data, your environment.
HIPAA-compliant and customer-hosted. Patient data never leaves your infrastructure.
You stay in control.
Agents carry the volume; your experts review exceptions, own edge cases, and sign off. No black-box automation.
See your AI workforce in action.
Book a 30-minute demo and we’ll show you exactly where Medikode cuts cost and recovers revenue across your cycle.