AI-Driven Revenue Intelligence

Close the Revenue Loop with Intelligent Coding, Billing & EMR Automation

SmartBillAI pairs a HIPAA-aware EMR backend with a fine-tuned medical NLP engine to automate coding, claims, and compliance end-to-end. Accelerate reimbursements, eliminate denials, and give clinicians a beautifully simple charting experience backed by enterprise-grade security.

98% Claim acceptance on first pass with payer-specific validation.
3x Faster coding throughput leveraging transformer-based NLP.
24/7 Automated monitoring, audit logging, and compliance reporting.

SmartBillAI Orchestrates Your Revenue Cycle

  • Medical Coding: Extract and assign ICD-10, CPT, and HCPCS codes using AWS Comprehend Medical or custom transformers.
  • Billing Automation: Generate payer-ready statements mapped to CMS guidelines.
  • Claims: Submit X12 837 & FHIR claims with live status checks.
  • Invoice Management: Encrypt, store, and deliver invoices across patient channels.

Why Providers Love SmartBillAI

Purpose-built for health systems, ambulatory networks, and specialty groups, SmartBillAI streamlines every billing touchpoint while safeguarding protected health information. Our unified platform delivers clinical depth, payer intelligence, and seamless interoperability.

Medical Coding

  • Automatically extracts diagnoses & procedures from structured and unstructured notes.
  • Assigns ICD-10, CPT, and HCPCS codes with explainable AI confidence scoring.
  • Continuously learns from provider feedback to keep pace with payer updates.

Billing Automation

  • Payer-specific rule engine covers Medicare, Medicaid, and private insurers.
  • CMS guideline validation eliminates costly front-end denials.
  • Automated reconciliation and revenue analytics dashboards.

Claim Submission

  • One-click export to X12 837 or FHIR endpoints for every major payer.
  • Real-time status tracking with proactive error resolution workflows.
  • Audit-ready claim history with structured JSON payloads.

Invoice Management

  • Secure AWS S3 storage with KMS encryption and lifecycle policies.
  • Automated patient billing via encrypted email or portal notifications.
  • Role-based access ensures the right staff sees the right invoices.

Audit & Compliance

  • HIPAA-grade authentication with AWS Cognito MFA and RBAC.
  • PHI encryption at rest and in transit with centralized key control.
  • Immutable audit trails capture who, what, when, and before/after states.

Smart EMR Backbone

  • Modular FastAPI EMR that plugs into existing EHR infrastructure.
  • FHIR-ready adapters accelerate interoperability initiatives.
  • Extensible design for telemedicine, CDS, and partner integrations.

Enterprise Architecture Built for Scale & Compliance

SmartBillAI is engineered with a 12-factor, containerized architecture that respects healthcare regulations while delivering rapid innovation. Every layer is designed for observability, resilience, and auditability.

Core Stack

  • FastAPI services with Pydantic v2 validation.
  • SQLAlchemy 2.0 ORM + Alembic migrations on PostgreSQL.
  • Docker & docker-compose bundles API, DB, Redis, and Celery workers.

Security Posture

  • JWT auth with Argon2/Bcrypt hashing and strict RBAC.
  • Centralized PHI redaction, rate limiting, and HTTPS enforcement.
  • Comprehensive audit logs stored in a dedicated database table.

Automation & Ops

  • Celery background jobs for coding, claims, and nightly pg_dump backups.
  • Redis-backed caching and rate limiting to protect critical endpoints.
  • Makefile-driven developer experience with linting, testing, and migrations.

Developer Velocity

  • Pytest, httpx, and factory_boy test harness with ≥80% coverage.
  • OpenAPI, Swagger UI, and ReDoc ready for payer & partner reviews.
  • Example .env, seed scripts, and Postman collections for fast onboarding.

From Encounter to Reimbursement — Automated

Deploy SmartBillAI to deliver a complete patient-to-payment experience. Our EMR-ready API orchestrates clinical workflows, revenue operations, and SmartBillAI billing intelligence in a single, secure platform.

Clinical & Operational Workflows

  • PATIENT LIFECYCLE Register patients, create encounters, track vitals, and close visits with structured SOAP notes.
  • ORDERS & RESULTS Generate lab/radiology/referral orders, attach LOINC-based results, and trend longitudinal data.
  • APPOINTMENTS Coordinate provider schedules across in-person and telemed visits with conflict detection.
  • DOCUMENTS Upload, index, and retrieve consent forms, reports, and attachments with signed URL access.

SmartBillAI Revenue Intelligence

  • CODING SUGGESTIONS POST /billing/coding-suggest assembles encounter data and returns AI-driven ICD-10 & CPT recommendations.
  • CLAIM SUBMISSION Automated generation of 837P-like payloads with submit_claim and real-time status retrieval.
  • AUDIT LOGS Every write operation captures before/after snapshots, actor identity, IP, and timestamp.
  • INSIGHTS & ALERTS Dashboards surface denial drivers, coding drift, and payer-specific performance trends.

Simple, Transparent Pricing

Choose the plan that's right for your practice. Scale as you grow with flexible pricing designed for healthcare providers of all sizes.

Starter

For solo practitioners

$299 /month
  • ✓ Up to 200 claims/month
  • ✓ Basic medical coding (ICD-10, CPT)
  • ✓ Email support
  • ✓ Standard reporting
  • ✓ 2 user accounts
  • ✓ HIPAA-compliant storage
Most Popular

Professional

For small to medium practices

$599 /month
  • ✓ Up to 500 claims/month
  • ✓ Advanced coding + billing automation
  • ✓ Priority email & phone support
  • ✓ Custom reports & analytics
  • ✓ 5 user accounts
  • ✓ API access
  • ✓ Real-time claim tracking

Practice

For growing practices

$999 /month
  • ✓ Up to 1,500 claims/month
  • ✓ Full EMR integration
  • ✓ Dedicated account manager
  • ✓ Advanced analytics & dashboards
  • ✓ 15 user accounts
  • ✓ White-label options
  • ✓ Priority support

Enterprise

For health systems & networks

Custom pricing
  • ✓ Unlimited claims
  • ✓ Full platform access
  • ✓ 24/7 phone support
  • ✓ Custom integrations
  • ✓ Unlimited users
  • ✓ On-premise deployment option
  • ✓ 99.9% SLA guarantee

Calculate Your Costs

Recommended Plan

Estimated Monthly Cost $299

Base plan: $299/month

Includes 200 claims

Feature Comparison

Feature Starter Professional Practice Enterprise
Monthly Claims Up to 200 Up to 500 Up to 1,500 Unlimited
User Accounts 2 5 15 Unlimited
Medical Coding (ICD-10, CPT) ✓ ✓ ✓ ✓
Billing Automation Basic ✓ Advanced ✓ Advanced ✓ Advanced
Claims Submission ✓ ✓ ✓ ✓
Real-time Tracking — ✓ ✓ ✓
EMR Integration Basic Basic ✓ Full ✓ Full
API Access — ✓ ✓ ✓
Custom Reports Standard ✓ ✓ Advanced ✓ Advanced
Analytics Dashboard Basic ✓ ✓ Advanced ✓ Advanced
Support Email Email & Phone Priority 24/7 Dedicated
Account Manager — — ✓ ✓
White-label Options — — ✓ ✓
Custom Integrations — — Add-on ✓ Included
On-Premise Deployment — — — ✓
SLA Guarantee 99% 99.5% 99.9% 99.9%

Frequently Asked Questions

Can I change plans later?

Yes! You can upgrade or downgrade your plan at any time. Changes take effect at the start of your next billing cycle.

What if I exceed my claim limit?

We'll notify you when you reach 80% of your limit. Overage claims are billed at $0.75 per claim, or you can upgrade to the next tier.

Is there a setup fee?

No setup fees for Starter and Professional plans. Practice plans include complimentary onboarding. Enterprise includes full implementation support.

How does billing work?

All plans are billed monthly in advance. We accept credit cards and ACH transfers. Annual plans receive a 15% discount.

What's included in support?

All plans include access to our knowledge base and email support. Higher tiers include phone support and dedicated account management.

Can I try before I buy?

Yes! We offer a 14-day free trial on all plans. No credit card required to start your trial.

HIPAA-First, Always

Security is integrated into every line of code. SmartBillAI combines AWS-native controls with healthcare-centric safeguards to ensure PHI remains protected without slowing your teams down.

Authentication & Access

  • AWS Cognito with MFA and adaptive risk scoring.
  • Role-based access (ADMIN, PHYSICIAN, NURSE, BILLING, FRONTDESK, PATIENT_READONLY).
  • Field-level protections keep sensitive billing and clinical notes secure.

Data Protection

  • KMS-backed encryption for all PHI at rest and TLS 1.2+ in transit.
  • Nightly backups, disaster recovery playbooks, and breach monitoring.
  • Structured logging with PHI redaction and tamper-proof audit trails.

Operational Readiness

  • Comprehensive security.md and runbooks for compliance teams.
  • Continuous vulnerability scanning, ruff/black/mypy lint gates, and CI coverage.
  • Optional webhook consumer for SmartBillAI claim updates.

Ready to Transform Your Revenue Cycle?

Launch SmartBillAI in weeks, not months. Our implementation specialists will connect your EMR, migrate historical claims, and configure payer-specific automations tailored to your network.

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