Documentation readiness
Identify the attested note version, encounter context, missing inputs, and responsible owner. Keep an incomplete record visible while it is being clarified.
QuickCode · AI-assisted medical coding
AI medical coding with qualified coder review
Bring suggestions and supporting documentation into the coding worklist. Review, correct, clarify, and approve the result before the billing handoff. Evaluate the workflow with your staff and representative encounters.
For coding teams, CDI specialists, billing operators, and coding managers.
What is AI medical coding software?
AI-assisted medical coding software proposes suggestions from encounter documentation for qualified staff to assess.
The QuickCode workflow brings an attested encounter into a worklist, presents proposed suggestions and available evidence, supports documentation clarification, and sends reviewed work to the claim workflow. Coders assess the source record, correct or reject a suggestion, and approve the final result within their authority.
Confirm the setting, specialty, supported inputs, review requirements, and return handoff in your proposed scope. A confidence indicator or accepted suggestion does not independently establish payer acceptance or reimbursement.
Make each unresolved encounter actionable
Assess where the coding workflow needs evidence, a reviewer decision, or a provider clarification.
Reviewer control
Inspect suggestions and available support before accepting them. Confirm permissions to correct, reject, override, or approve a result, with an accountable escalation route.
Claim handoff
Confirm what constitutes approved work, which system retains the final result, and what reaches the claim editor. Keep review status and unresolved issues traceable.
Evaluate the workflow with the people who use it
Define responsibilities and acceptance criteria for each team before the pilot.
Coding teams
Inspect evidence, resolve disagreements, correct suggestions, and compare review time and difficult cases against the current process.
CDI and clinicians
Review the clarification request, provider handoff, response, reprocessing, and escalation for unanswered documentation questions.
Billing and RCM leaders
Validate the approved-result handoff, unresolved case visibility, queue ownership, and downstream claim-readiness checks.
IT and finance
Confirm access and data flow, integration failures, written pricing, remaining staff work, support responsibilities, and measurable pilot costs.
From attested documentation to reviewed work
The internal workflow description supports these operating stages. Validate their availability and behavior in your proposed environment.
1. Identify the encounter
Confirm the attested documentation, encounter identity, input completeness, and worklist owner.
2. Review suggestions
Inspect the proposed result, available source support, and confidence or uncertainty indicators. Assess conflicting or missing evidence.
3. Resolve clarification
Prepare and review the documentation question, route it to the appropriate provider workflow, and keep the response with the encounter.
4. Correct and recheck
Record reviewer corrections or rejections and inspect the available configured checks. Confirm unresolved-case handling and escalation.
5. Approve the handoff
An authorized reviewer approves the result for the claim workflow. Validate the returned fields, status, and traceable history.
8-step pre-submission scrub
Every code is checked against 8 payer rule layers before it leaves the editor.
QuickCode runs an automated 8-step claim scrub on every encounter — the same NCCI, MUE, LCD/NCD, and modifier checks that historically catch denials post-submission, run before the claim reaches the payer. Coding-driven denials drop from 4–7% of claims to under 1.5%, with NCCI/MUE denials specifically falling below 0.5%.
- 1NCCI
- 2MUE
- 3Medical Necessity
- 4LCD / NCD
- 5Frequency
- 6Bundling
- 7Documentation
- 8Modifier
NCCI → MUE → Medical Necessity → LCD/NCD → Frequency → Bundling → Documentation → Modifier
1
NCCINational Correct Coding Initiative
Practitioner-to-Practitioner edits flag CPT pairs that can't be billed together without a justifying modifier (e.g., 93000 with 99214). The scrub suggests the right modifier or removes the conflict.
2
MUEMedically Unlikely Edits
Per-code daily quantity limits enforced for every CPT/HCPCS line. If a unit count exceeds the CMS MUE for the code, the line is flagged before it leaves the editor.
3
Medical NecessityDiagnosis-to-procedure linkage
Every CPT must point to an ICD-10 that supports medical necessity. Unsupported procedures fail the scrub and trigger a CDI clarification rather than a denial later.
4
LCD / NCDLocal & National Coverage Determinations
Medicare coverage policies are checked at the MAC and national level. The scrub catches non-covered diagnoses, frequency limits, and documentation requirements before submission.
5
FrequencyPer-patient frequency limits
Annual physicals, screening colonoscopies, well-woman exams, and other frequency-limited services are checked against the patient's claim history so duplicates never reach the payer.
6
BundlingCPT bundling rules
CCI bundling, separate-procedure rules, and global-period edits collapse codes that should be billed as one. The scrub explains why and shows the correct combined billing.
7
DocumentationDocumentation sufficiency
Each suggested code is linked back to the exact note evidence. If E/M level, time, or procedure detail isn't documented, the line fails before billing — no invented support.
8
ModifierModifier validation
Modifiers (25, 59, X{EPSU}, 26, TC, 76, 77, RT/LT, etc.) are validated against the procedure, payer policy, and place of service. Wrong or missing modifiers are auto-suggested or flagged.
PASS
All 8 layers clear — claim is cleared to flow to the Claim Editor and out to the payer.
WARN
Edits with auto-fix suggestions or modifier additions. Coder reviews, accepts, and re-runs the scrub.
FAIL
Claim is held — cannot leave the editor unless a manager overrides with a documented reason. Every override is logged.
Ask for evaluation evidence that matches your work
A general accuracy percentage or dataset count does not establish performance for your encounters.
Qualified reference review
Request the sample size, setting, specialty mix, complexity, exclusions, reviewer method, disagreements, and model or configuration version.
Difficult-case coverage
Include sparse, conflicting, and incomplete documentation as well as straightforward encounters. Record suggestions rejected or corrected by qualified staff.
Operational results
Measure review time, clarification, queue burden, corrections, and the claim handoff. Report adjudicated outcomes separately from suggestion agreement.
Keep decisions with accountable reviewers
Confirm who performs, reviews, and escalates each stage of the proposed workflow.
Coding reviewer
Assesses suggestions and evidence, records corrections, and approves or rejects the result according to assigned authority.
CDI and provider owner
Reviews a documentation question, supplies or obtains the appropriate response, and resolves or escalates outstanding clarification.
Coding manager and billing owner
Sets review and acceptance requirements, monitors exceptions, approves configuration changes, and confirms the claim handoff.
Implement a scoped, reviewable pilot
Agree on responsibilities, access, and acceptance before changing the live workflow.
- Define setting, specialty, encounter population, exclusions, and the baseline workflow.
- Confirm permitted records, data handling, access, matching, and the current claim handoff.
- Validate representative inputs and suggestions with qualified reviewers; record evidence gaps and disagreements.
- Run a monitored pilot covering review, correction, clarification, failures, and escalation.
- Approve acceptance, release, support, change control, and rollback with the responsible owners.
Request relevant proof
Ask for an approved case study with the cohort, baseline, reference-review method, time window, scope, and measured results. Internal workflow descriptions and sample screens do not independently establish customer outcomes.
Agree on timing and ownership
The implementation schedule depends on access, data readiness, the proposed connection, reviewer availability, and acceptance criteria. Request a written plan with owners, dependencies, support, and exclusions; a fixed go-live window is not assumed.
Medicare Advantage & ACO Risk Adjustment
HCC Capture, Hierarchy Exclusion & CMS-HCC v28 RAF Scoring
QuickCode validates HCC capture, applies CMS hierarchy automatically, and produces a CMS-submission-ready RAF score for every Medicare Advantage, ESRD, and risk-bearing-contract chart — with an audit trail that links every captured HCC back to its source ICD-10, model version, hierarchy decision, and reviewer.
1
ICD-10 to HCC crosswalk
Every ICD-10 on the encounter is mapped to its CMS-HCC v28 category, including dual-mapped codes (e.g., E11.22 captures both diabetes and CKD HCCs).
2
Hierarchy exclusion applied
CMS hierarchy automatically suppresses lower-severity HCCs when a more specific condition is captured (e.g., HCC 17 suppresses HCC 18). The dominant HCC must be supported by documentation.
3
Segment + RAF calculation
Demographic flags (dual-eligible, disabled, institutional, ESRD) drive segment selection, then Intercept + Demographics + HCC factors + Interactions are summed and normalized into the final RAF score.
4
CDI query for missing capture
If a documented chronic condition (CKD stage 3, diabetic neuropathy, etc.) isn't captured, QuickCode opens an HCC suggestion query to the provider — not an invented code.
RAF score breakdown
QuickCode shows the math behind every RAF score so coders and clinical reviewers can defend the number, not just accept it.
- InterceptBase value for the segment
- DemographicsAge, sex, dual-eligible, disabled, institutional, ESRD
- HCC factorsCoefficients for each captured, hierarchy-cleared HCC
- InteractionsDisease + disabled / dual interaction terms
- NormalizationPayment-year normalization factor applied to the raw score
Why this matters for Medicare Advantage
- 94%+HCC capture of identified opportunities once QuickCode is in the workflow, vs. a typical 70–75% recapture baseline.
- CMS-HCC v28v28 is the default for 2026, with the right model and payment-year normalization factor applied automatically so practices don’t lose more than the 3.1–3.7% phase-in compression.
- < 48 hrsClinical review cycle for borderline captures, with optional reviewer sign-off enforced when
riskAdjustmentHumanReviewRequiredis on — the score isn’t CMS-submission-ready until a reviewer signs off.
Comprehensive AI Medical Coding Features
Review the available feature and version scope with qualified staff during your demonstration.
📋
Comprehensive Code Extraction
- ICD-10 diagnosis codes with full specificity
- CPT procedure codes with modifiers
- HCPCS codes for supplies and services
- Revenue codes for facility billing
- DRG assignment for inpatient cases
- NDC codes for medications
- ICD-10 AM for international coding
🎯
Reviewer evidence
- Inspect supporting text and uncertainty indicators
- Review corrections, rejections, and clarification
- Validate agreement with a qualified reference review
- Confirm the available decision history and exports
🔌
Proposed integration scope
- Validate the permitted input and encounter matching
- Confirm returned fields and reviewer status
- Inspect failures, retries, duplicates, and recovery
- Agree ownership and support for the current environment
🔒
Deployment and procurement
- Review access, data flow, retention, and agreements
- Confirm permitted historical-data or training use
- Request current evidence for any security commitment
- Request a written scope and itemized quote
CDI Clarification Loop
Resolve Ambiguous Documentation Without a Second AI Pass
When a chart can't be coded without provider input, QuickCode runs a structured CDI clarification loop — query into the EHR inbox, answer in-place, deterministic reprocess. Codes finalize with a full audit trail and zero extra AI spend.
📥
1
CLARIFICATION_REQUIREDStructured query lands in the EHR inbox
When the engine flags ambiguity (unspecified ICD code, modifier 25 question, panel ambiguity like BMP vs CMP), QuickCode sends a structured CDI query — pulled from the templates library — straight to the provider's EHR inbox as a portal task. No new login, no email back-and-forth.
✍️
2
Answer in-placeProvider answers without leaving the chart
Each query specifies an expected answer type (single_choice, multiple_choice, boolean, or text) so the provider can resolve it in seconds — e.g., "Was the diabetes Type 1 or Type 2?" or "Was the wound debridement to skin, fat, muscle, or bone?". The nightly autoEscalateCdiQueries job catches anything past SLA.
🔄
3
REPROCESSINGReprocess with Answers — no fresh AI call
When the answer comes back into the Clarifications tab, the coder clicks Reprocess with Answers. The engine deterministically re-resolves the codes — no fresh AI round-trip, no new token spend. The encounter status moves to COMPLETED_WITH_CLARIFICATIONS with the full conversation in the audit trail.
Status flow
CLARIFICATION_REQUIRED → REPROCESSING → COMPLETED_WITH_CLARIFICATIONS
Every resolved code is annotated "resolved via clarification answer," and the full provider conversation is captured in the audit log — ready for payer scrutiny without manual chart chasing.
Compare workflows with the same evidence requirements
Use a matched evaluation for an internal coding workflow, outsourced delivery, or AI-assisted software.
| Criterion | What to inspect | Evidence needed |
|---|---|---|
| Evaluation scope | Match setting, specialty, documentation, complexity, and exclusions. | Use the same reference cohort and qualified reviewer method for each option. |
| Review and exceptions | Inspect rejected suggestions, clarification, escalation, and final approval. | Record evidence gaps and the human work remaining after automation. |
| Integration | Validate inputs, matching, returned fields, failure handling, and support. | Request evidence for the actual environment; shared formats do not prove a connector. |
| Costs and workload | Compare written fees, setup, recurring charges, and measured staff work. | Use a consistent cost boundary; no generic competitor price or productivity claim is assumed. |
| Outcome reporting | Separate suggestion agreement, operational burden, and adjudicated results. | Request dated, relevant, approved evidence rather than transferring results between cohorts. |
Validate the connection and the return handoff
Define the vendor, version, environment, permissions, input records, and review workflow with the team.
Inputs and matching
Inspect the proposed API, approved file process, or EHR interface. Validate attested documentation, encounter matching, required fields, missing inputs, and permitted access.
Reviewer visibility
Confirm which source evidence, uncertainty indicators, suggestions, and decisions are visible in the review console or existing work queue.
Return and recovery
Validate approved-result fields and status, duplicate handling, failures, retries, unresolved work, and reconciliation after recovery.
Implementation ownership
Identify who configures, validates, operates, and supports each handoff. A shared interface format does not establish a ready connector for every vendor or configuration.
Documentation, review, and the billing handoff
Establish usable inputs
Confirm that the encounter documentation is complete and attested, with the relevant service, provider, date, and payer context. When the record needs clarification, keep the encounter held and route the question to the clinician.
Inspect the review decision
Ask to see a suggestion alongside its supporting documentation and the review history. Evaluate how staff accept, edit, reject, or request clarification, and which actions require a supervisor. Define release controls for your specialty and operating model.
Trace accepted work downstream
Follow reviewed output into claim preparation and inspect the return path for corrections. Confirm the supported EHR and practice-system interfaces, reconciliation process, and handling of information changed after review.
Evaluate evidence on your own sample
Use an authorized, representative sample and an agreed human reference review to assess quality. Record specialty, case mix, review method, correction types, and held work. A headline accuracy percentage cannot establish suitability for a different practice.
Advertised per-chart pricing; confirm the proposed scope
The public QuickCode offer advertises $0.50–$1.00 per chart. Request a current written quote for your volume, complexity, integration, review workflow, and support.
Growth · $0.75/chart
Advertised pricing example. Confirm current eligibility, minimums, included features, support, and charges in the proposal.
Scale · $0.65/chart
Advertised pricing example. Confirm the workload, scope, implementation, support ownership, and commercial commitments.
Enterprise · $0.50/chart
Advertised pricing example. Confirm availability, proposed configuration, usage or third-party charges, and contractual terms.
Ask for an itemized quotation
Confirm the billable chart definition, included features, minimum commitments, onboarding, integration, any historical-data work, support, changes, renewal, usage and third-party charges, and exclusions. Scope and staff responsibilities should be clear before interpreting a unit price as the total operating cost.
Published examples do not automatically assign a tier by volume or establish free setup, unlimited use, a default SLA, sandbox access, or a payback period.
Compare costs using your own inputs
Enter your baseline costs and written proposal. Include the review work and charges that remain after the proposed change.
Your cost assumptions
All fields are required for an estimate. Enter zero explicitly for a cost that does not apply. Use the same workload and cost boundary for both workflows.
Estimated cost difference
Enter all six values to compare costs.
The proposed cost includes the quoted fee, remaining review work, and other recurring costs. The first-year difference also subtracts implementation cost. A negative difference means the proposed workflow costs more within these inputs.
This comparison assumes no denial reduction, recovered revenue, staff reduction, automatic tier assignment, or payback period. It is an estimate from your inputs; validate the workload and costs in the pilot.
Review deployment, access, and data-use terms
Request current evidence for the proposed environment and the commitments used in procurement.
Deployment and agreements
- Proposed hosting and processing locations
- Permitted records and applicable agreement
- Subprocessors, responsibilities, and incident process
User permissions and review
- Authentication and available access controls
- Reviewer, approver, and escalation permissions
- Audit visibility and export requirements
Retention and data use
- Input, output, history, backup, and evaluation-data retention
- Deletion and export process, timing, and exceptions
- Any proposed training, isolation, or data-use restrictions
Evidence and service commitments
- Current assessment scope and period for any certification claim
- Availability, recovery, support, and escalation terms
- Exclusions and the services actually covered by the proposed commitment
Discuss current documentation with the team and review the security information. General product descriptions do not establish deployment-specific compliance or certification.
QuickCode buyer questions
Review workflow, integration, implementation, evaluation evidence, commercial scope, and responsibilities.
Product Fundamentals
QuickCode is AI-assisted medical coding software for coding teams, CDI specialists, billing operators, and coding managers. The documented workflow proposes suggestions from encounter documentation, presents them for review, supports clarification, and hands reviewed work to the claim workflow. Qualified staff retain responsibility for the final coding decision; confirm the available workflow in a demonstration.
Discuss your attested notes, encounter records, reports, documents, and existing data feeds with the team. Validate representative inputs, document versions, matching, missing fields, and error handling in the proposed connection. A listed integration format does not establish that every document or vendor configuration is supported.
Inspect proposed suggestions, available supporting text, confidence indicators, documentation questions, and the reviewer decision history in the demo. Confirm the output fields, return path, and missing-evidence behavior for your implementation. Suggestions require review before they become approved billing data.
Define the setting, specialty, documentation, and case complexity in the proposed scope. Ask the team to demonstrate representative cases and the review or escalation path for each. Do not assume an outpatient demonstration establishes equivalent support or performance for complex inpatient work.
Confirm which suggestion and validation features are available for your setting, payer, and workflow. A qualified reviewer should inspect the supporting documentation and any finding before accepting a suggestion. This page does not provide clinical coding instructions or establish that every policy check is included.
A second-pass review workflow is an option to discuss during scoping. Define which records enter the queue, what the reviewer sees, how disagreements are resolved, and which system retains the approved result. Confirm the available configuration and permissions before starting a pilot.
Content updated .
Free CMS coding reference
Coders evaluating QuickCode can check the same public CMS tables a reviewer would consult.
QuickCode Works With the Full QuickIntell Platform
QuickScribe — AI Medical Scribe
Discuss the reviewed documentation and attestation handoff into the coding workflow.
QuickRCM — End-to-End AI RCM
Connect coding review with the proposed claims, payment, and follow-up workflows.
QuickAuth — Prior Authorization
Confirm the available authorization workflow and how its status reaches claim preparation.
QuickERA — Payment Posting
Review the remittance conversion workflow and the handoff to payment posting.
Evaluate QuickCode against your review workflow
Bring your setting, specialty mix, encounter volume, integration environment, responsible reviewers, and acceptance requirements.
Ask to see a representative suggestion and its available evidence, a correction, an unresolved case, the clarification handoff, reviewer approval, and the return to the claim workflow. Confirm scope, implementation, commercial terms, and data handling before the pilot.
