Get paid faster. Let an AI agent handle your medical billing.
A subscription-based medical billing workspace where an AI agent helps teams check eligibility, review claims, explain denials, and guide the next action without forcing users into a complex RCM platform.
Why is this claim not ready to submit?
The claim needs three fixes before submission: refresh eligibility, correct the missing modifier, and confirm prior authorization.
AI agent features for everyday billing work.
The goal is not to replace every RCM system. The goal is to give billing teams an AI agent that helps them understand issues faster and move claims forward with less manual research.
Eligibility AI agent
Check coverage and catch subscriber or payer issues before claims go out.
Claim review AI agent
The AI agent finds missing fields, coding concerns, modifier issues, and payer-rule risks.
Denial AI agent
The AI agent explains denial reasons and suggests correction, appeal, or follow-up actions.
ERA review AI agent
The AI agent summarizes payments, adjustments, underpayments, and posting exceptions.
Patient chart summary AI agent
The AI agent condenses charts and encounter notes into a quick, billing-relevant summary.
Medical coding AI agent
The AI agent suggests CPT, ICD-10, and modifier codes based on documentation, ready for review.
A simple conversational billing screen.
The AI agent answers billing questions in plain language, and a dedicated usage screen shows exactly what's been used and what it costs — so the interface stays familiar and nothing about the subscription feels hidden.
Explain denial CO-16 for this claim and tell me what the AI agent recommends next.
CO-16 means the payer needs additional or corrected information. For this claim, the missing item is the authorization reference. Add the authorization number, attach supporting documentation, and resubmit through the correction workflow.
Subscription plans with simple AI credits.
Start with a low monthly plan, then upgrade as claim volume, users, and AI agent usage grow.
For solo providers and low-volume practices.
- 2 users
- 400 AI credits/month
- 150 claims + 150 ERA items
- 300 eligibility checks
For small billing teams with growing volume.
- 5 users
- 1,500 AI credits/month
- 600 claims + 600 ERA items
- Denial drafts and integrations
For multi-provider clinics and RCM teams.
- 10 users
- 4,000 AI credits/month
- 2,000 claims + 2,000 ERAs
- Advanced analytics and audit logs
How AI credits work by feature
AI credits are simple usage units for AI-assisted billing actions. Each common feature uses a small number of credits so customers can estimate usage easily.
What the user should be able to do quickly.
For small practices
Give the front office and billing admin a simple place to check problems before claims are submitted.
- Check eligibility before visits and billing
- Review claims before submission
- Understand why a denial happened
- Prepare payer follow-up notes
For billing teams
Help billers work from queues instead of searching across payer portals, files, and spreadsheets.
- Prioritize high-value claim issues
- Summarize ERA and payment exceptions
- Create correction and appeal drafts
- Track usage, edits, and audit history
One orchestrator. One LLM brain. A team of AI agents.
A multi-agent orchestrator reads every request, calls the LLM to reason about it, and activates the right specialist agent for the job — so billing teams get one simple screen backed by a coordinated AI system underneath.
Every hand-off is metered in AI credits, logged for audit, and reviewed by a human before anything is submitted or sent.
From visit to payment in five steps.
Check coverage
Verify eligibility before the claim is created.
Review claim
Find missing fields, modifiers, and payer-rule concerns.
Submit
Prepare claims for clearinghouse or billing workflow submission.
Post ERA
Review payment, adjustment, and variance details.
Recover denials
Explain issues and draft correction or appeal actions.
Built for healthcare billing controls and AI agent governance.
Tenant isolation
Separate practice data, users, roles, and activity logs.
Audit trail
Track claim edits, AI suggestions, user actions, and exports.
Human review
AI recommends actions; billing users approve before submission.
BAA-ready design
Plan for HIPAA-aligned cloud hosting, access controls, and vendor agreements.
Turn billing complexity into a simple AI workspace.
HiPaaS can help design, build, and launch MedibillAI as a subscription-based medical billing AI agent.