End-to-End E/M Coding and Critical Care Billing Compliance
Use AI-driven logic to apply the correct E/M codes and identify when critical care time can be billed separately. Get faster reimbursements and fewer denials with built-in compliance for time, complexity, and documentation requirements.
Trusted by the best in the industry
Precision Coding for Every Encounter
- Determines the correct E/M level using AI based on time, complexity, and medical decision making
- Automatically checks documentation for required elements before code selection
- Prevents undercoding or overcoding that leads to audits or lost revenue
Clarity in Overlapping and Exclusive Critical Care Scenarios
- Validates if E/M can be billed in addition to critical care based on payer rules
- Recognizes 30-minute time thresholds and qualifying diagnoses
- Differentiates non-critical care time to meet documentation and billing requirements
Denial Prevention with Built-In Coding Intelligence
- Flags unbillable combinations like overlapping services or bundled time
- Detects missing or conflicting information in real time
- Generates audit-ready notes aligned with E/M coding guidelines
Advanced Features Built for Complex Coding Workflows
Encounter Context Engine
Analyzes full clinical narrative and encounter metadata to detect billing nuances beyond time or complexity.
- Distinguishes between evaluation visits and procedural encounters
- Applies logic for visit types like consultations, follow-ups, or post-discharge
- Detects inconsistencies between diagnosis, service type, and documentation intent
- Helps avoid misclassification of E/M type or level based on context clues
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Prolonged Service Timer
Supports precise billing for extended encounters by tracking and validating prolonged service thresholds.
- Auto-detects eligible time blocks beyond base E/M thresholds
- Integrates with timestamp data for multi-provider or rolling care sessions
- Applies correct add-on codes (e.g., G2212) as per payer rules
- Flags when prolonged time cannot be billed due to insufficient base time
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Coder Workflow Sync + Override Controls
Keeps humans in the loop while streamlining the heavy lifting — ideal for BPOs and high-volume settings.
- Presents pre-suggested codes with documentation reasoning
- Allows manual override with built-in logic prompts
- Tracks coder inputs for audit trail and performance metrics
- Reduces time spent resolving internal coding disputes or denials
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What Sets Us Apart
Expert-Level Compliance Logic
- Built-in AMA and CMS rule sets for E/M and critical care coding
- Adjusts for payer-specific bundling and separation rules
- Maintains accuracy across inpatient, outpatient, and emergency care settings
Speed and Accuracy Combined
- Suggests correct codes to coders and flags errors before submission
- Delivers over 95% accuracy for E/M coding
- Reduces denials tied to time and documentation issues
Interoperable and Audit-Ready
- Integrates with major EHRs and PM systems via HL7 and FHIR
- Tracks critical care time, supporting notes, and code history
- Complies with HIPAA and payer audit policies
Results You Can Trust
RapidClaims delivered what other vendors only promised. We've seen a 30% reduction in AR days within one quarter, unlocking $2.5M in accelerated cash flow. Their platform adapts to our specific workflows instead of forcing us to change our processes.
CFO, Major Health System
$2.5M
Accelerated cash flow
30%
Reduction in AR days
"With RapidClaims, we're maximizing our limited resources while improving revenue capture by 5%. Our team now spends more time on patient care and less on administrative tasks."
Director HIM, Federally Qualified Health Center
5%
↑ increased revenue
40%
Reduction in coding and billing costs
RapidRisk transformed our value-based care documentation, improving RAF by 15% and reducing documentation gaps by 22%. This directly impacts our shared savings and quality metrics.
Medical Director, Leading Accountable Care Organization
15%
↑ RAF
45%
New conditions identified
Our clean claim rate jumped from 92% to 99% with a 96% first pass yield rate. With RapidClaims, we improved the productivity of our coding staff by 100%. Our team only focuses on complex cases that require human expertise.
VP Revenue Cycle, Multi-Specialty Physician Group
27%
Reduction in claim denials
70%
Reduction in cost to collect
Ensure Clean Claims for Every Visit, Even in Complex Care Settings
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