Platform/Revenue Cycle/Claims
Revenue Cycle · Module 07

Clean claims First time

A coding engine reads the Scribe note and builds the claim. It scrubs for NCCI edits, scores the odds of a denial, and hands you the fixes, so the CMS-1500 goes out clean the first time.

Pricing

See it in action

Watch how Whadata Claims scrubs claims before they leave

Videos coming soon

01 · Coding

The codes come from the visit

A coding engine reads the Scribe note and pulls the diagnoses and procedures for the claim: ICD-10 with HCC categories, CPT and HCPCS with units and charges. Everything lands on an editable worksheet where you can search codes, adjust, and confirm before anything goes out.

  • Diagnoses and procedures extracted from the note
  • ICD-10-CM with HCC category lookup
  • CPT and HCPCS with modifiers, units, and charges
  • Search and edit codes on a worksheet
Scribe to ClaimsCoded chart with claims codes
02 · NCCI scrub

A scrub that tells you why

Before the claim leaves, it runs through NCCI edits. The scrubber catches procedure-to-procedure conflicts and medically-unlikely unit counts, and explains each one in plain language with the codes involved and the fix, not a generic reject.

  • NCCI procedure-to-procedure (PTP) edits
  • Medically Unlikely Edits (MUE) on units
  • Bundling and component conflicts flagged with the reason
  • Suggested modifier when one applies
NCCI scrub results
03 · Denial prediction

See the denial before the payer does

Each claim gets a denial-probability score and a ranked list of fixes: tighten an unspecified diagnosis, drop a bundled code, add a modifier. Every suggestion shows how much it lowers the risk, so you can clean the claim up and generate the CMS-1500 or superbill with confidence.

  • Denial probability scored per claim
  • AI fixes: increase specificity, remove bundled codes, add modifiers
  • Each suggestion shows its estimated impact
  • Generate the CMS-1500 claim form and superbill
Denial score + suggestions
Specs

Under the hood

The code sets, edits, and outputs Claims actually speaks.

DiagnosesICD-10-CM with HCC category lookup
ProceduresCPT and HCPCS Level II with modifiers, units, and charges
ExtractionCodes pulled from the Scribe note by a RAG coding engine
ScrubbingNCCI edits: procedure-to-procedure (PTP) and Medically Unlikely Edits (MUE)
Denial predictionPer-claim probability with ranked, impact-scored AI fixes
OutputCMS-1500 (HCFA 02/12) claim form PDF and superbill
ComplianceHIPAA & HITECH aligned, encrypted in transit and at rest, full audit trail, BAA included

Get paid for the work you did

Codes from the visit, an NCCI scrub, and a denial score, on a working route from chart to claim.

See pricing